Cardiometabolic traits mediated the relationship from urinary polycyclic aromatic hydrocarbons metabolites to heart rate variability reduction: A community-based study

Polycyclic Aromatic Hydrocarbons (PAHs) exposure was related with metabolic syndrome (MetS) and heart rate variability (HRV) reduction, and HRV was also affected by cardiometabolic traits. However, the role of cardiometabolic traits in the associations from PAHs exposures to HRV was largely unknown. We conducted this study to investigate whether the relationship between PAHs exposure and HRV reduction was mediated by cardiometabolic traits. Levels of urinary polycyclic aromatic hydrocarbons metabolites (OH-PAHs), 10min-HRV, and metabolic traits were accurately measured for 2476 participants from Wuhan-Zhuhai (WHZH) cohort. Single mediator and multiple mediator models were used to evaluate the mediation effects of cadiometabolic traits. The concentrations of ΣOH-PAHs ranged from 4.20 to 8.63 mg/mmol Cr. When compared with the lowest tertile, ΣOH-PAHs in the highest tertile were significantly related with 20% (95% confidence interval [95%CI]:1%, 40%), 35% (95%CI: 14%, 56%), 22% (95%CI: 1%, 44%), and 38% (95%CI: 9%, 68%) decreases in very low frequency (VLF), low frequency (LF), high frequency (HF), and total power (TP) for participants with MetS, respectively. No statistically significant associations between ΣOH-PAHs and HRV indices were observed for participants without MetS. Similar results were found when we investigated the relationships between OH-PAHs and HRV indices by three groups of OH-PAHs (including total hydroxynaphthalene [ΣOHNa], total hydroxy fluorene [ΣOHFlu], and total hydroxyphenanthrene [ΣOHPh] metabolites). Further, mediation analysis suggested that cardiometabolic traits, including fasting glucose (GLU), high density lipoprotein (HDL), and blood pressure partially mediated the relationship from ΣOH-PAHs to HRV reduction. GLU was the strongest mediator, with mediation percentages of 15.70% for VLF, 14.70% for LF, 43.03% for HF, and 5.61% for TP. Our study found that the relationships between OH-PAHs and HRV reduction differed among participants with and without MetS, and these relationships were found to be partially mediated by cardiometabolic traits, especially fasting glucose. Further studies are encouraged to validate our findings and investigate potential mechanisms.