Urinary Metals and Heart Rate Variability: A Cross-Sectional Study of Urban Adults in Wuhan, China

BackgroundEpidemiological studies have suggested an association between external estimates of exposure to metals in air particles and altered heart rate variability (HRV). However, studies on the association between internal assessments of metals exposure and HRV are limited.ObjectivesThe purpose of this study was to examine the potential association between urinary metals and HRV among residents of an urban community in Wuhan, China.MethodsWe performed a cross-sectional analysis of 23 urinary metals and 5-min HRV indices (SDNN, standard deviation of normal-to-normal intervals; r-MSSD, root mean square of successive differences in adjacent normal-to-normal intervals; LF, low frequency; HF, high frequency; TP, total power) using baseline data on 2,004 adult residents of Wuhan.ResultsAfter adjusting for other metals, creatinine, and other covariates, natural log-transformed urine titanium concentration was positively associated with all HRV indices (all p < 0.05). Moreover, we estimated negative association...