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Sex hormones mediated 15.41%–79.84% of the DEET–bone associations, with additional serial mediation effects among TT, E2, and 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\nJournal of Advanced Research  \njournal [homepage: www. elsevier. com/locate/jare](homepage: www. elsevier. com/locate/jare)  \n| Original Manuscript\u003Cbr>From repellent to risk: DEET’s adverse effects on hormones and bone health in kids |  |  | |\n| --- | --- | --- | --- |\n| Xinyu Zhu a, 1, Wanlu Liu a, 1, Baihao Lin a, 1, Haixia Qian b, 1, Mengya Xu a, Yuyu Zheng a School of Public Health, Guangzhou Medical University, Xinzao, Panyu District, Guangzhou 511436, China\u003Cbr>b Wuchang District Center for Disease Control and Prevention, Wuhan, Hubei, China |  | a, Yansen Bai a,⁎ |  |\n| h i g h l i g h t s\u003Cbr>• As the most active ingredient in commercial repellents, DEET is widely used in children and adolescents.\u003Cbr>• The hazardous effects of DEET exposure on sex hormones and bone mass remain unknown.\u003Cbr>• Increased DEET exposure was associated with decreased levels of sex hormones and bone mass.\u003Cbr>• Ages \u003C 12 years old and nonoverweight children are more sensitive to DEET interfered sex hormones and bone mass.\u003Cbr>• Sex hormones mediated the associations between DEET exposure and bone mineral density and content. | g r a p h i c a l a b s t r a c t\u003Cbr>|  |  |\n\na r t i c l e i n f o  \nArticle history:  \nReceived 20 September 2024 Revised 16 December 2024 Accepted 18 March 2025 Available online 21 March 2025  \nKeywords:  \nN, N-diethyl-3-methylbenzamide Sex hormones  \nBone mineral density Bone mineral content Children and adolescents  \na b s t r a c t  \nIntroduction: Early life bone accumulation, which predicts future fragility fracture risk, is intimately associated with sex hormones. N, N-diethyl-3-methylbenzamide (DEET) is the primary and most effective active ingredient widely used globally, especially among children and adolescents. However, the effects of DEET on sex hormones and bone mass remain unclear.  \nObjective: We aimed to explore the adverse effects of DEET exposure on bone mass and to elucidate the potential mediating roles of sex hormones in children and adolescents.  \nMethods: This cross-sectional study analyzed 864 children and adolescents from NHANES 2013–2016. Urinary 3-diethyl-carbamoyl benzoic acid (DCBA) was employed as a biomarker for DEET exposure. The study examined the relationships between DCBA, sex hormones, and bone mass, with a particular focus on evaluating the independent and serial mediation effects of sex hormones on DEET-bone mass associations.  \nResults: Increased DCBA was associated with decreased testosterone (TT), estrogen (E2), and free androgen index (FAI), alongside an increase in sex hormone-binding globulin (SHBG) levels, particularly pronounced among subjects \u003C 12 years [b%(95 % CI) = −0.081 (−0. 144, −0.017), −0.064 (−0. 114, −0.013),−0.101 (−0. 177, −0.024), and 0.020 (−0.009, 0.048), respectively] and non-overweight subjects [b%(95 % CI) = −0. 160 (−0.234, −0.086), −0. 103 (−0. 158, −0.048), −0. 195 (−0.282, −0. 107), and 0.035 (0.012, 0.058), respectively]. Negative dose–response relationships between DCBA and bone mass were  \n⁎ Corresponding author at: Institute for Chemical Carcinogenesis, School of Public Health, Guangzhou Medical University, Xinzao, Panyu District, Guangzhou 511436, China.  \nE-mail address: [baiyansen6@163.com](baiyansen6@163.com) (Y. Bai).  \n1 These authors contributed equally to this work and shared the ﬁrst authorship.  \n[https://doi.org/10.1016/j.jare.2025.03.037](https://doi.org/10.1016/j.jare.2025.03.037)  \n2090-1232/© 2025 The Author(s). Published by Elsevier B.V. on behalf of Cairo University.  \nThis is an open access article under the CC BY-NC-ND license ([http://creativecommons.org/licenses/by-nc-nd/4.0/](http://creativecommons.org/licenses/by-nc-nd/4.0/)).  \nX. Zhu, W. Liu, B. Lin et al. Journal of Advanced Research 79 (2026) 607–618  \nobserved in non-overweight participants [b%(95 % CI) = −0.011 (−0.018, −0.005) and −0.027 (−0.041,−0.013) for total bone mineral dens","cbCaig8WiF246W6F","https://ap.wps.com/l/cbCaig8WiF246W6F","pdf",2369012,12,"English","# Highlights\n## DEET exposure and sex hormones\n## DEET exposure and bone mass\n## Sex-hormone mediation\n# Abstract\n## Introduction\n## Objective\n## Methods\n## Results\n## Conclusions","[{\"question\":\"What does the study investigate about DEET in children and adolescents?\",\"answer\":\"It evaluates the adverse effects of DEET exposure on bone mass and clarifies how sex hormones may mediate these associations.\"},{\"question\":\"How is DEET exposure measured in the study?\",\"answer\":\"Urinary 3-diethyl-carbamoyl benzoic acid (DCBA) is used as a biomarker for DEET exposure.\"},{\"question\":\"What are the main findings regarding sex hormones and bone mass?\",\"answer\":\"Higher DEET exposure is associated with decreased testosterone, estrogen, and free androgen index, increased SHBG, and reduced bone mineral density and bone mineral content, with sex hormones mediating a substantial portion of the effects.\"}]","From repellent to risk - DEET’s adverse effects on hormones and bone health in kids | PDF",1790669060]