title: A community study of the effect of polycyclic aromatic hydrocarbon metabolites on heart rate variability based on the Framingham risk score.
abstract: OBJECTIVE
  To investigate the effects of the urinary metabolite profiles of background exposure to the atmospheric pollutants polycyclic aromatic hydrocarbon (PAH) and Framingham risk score (FRS), which assesses an individual's cardiovascular disease risk, on heart rate variability (HRV).
  
  
  METHODS
  The study conducted from April to May 2011 in Wuhan, China, included 1978 adult residents with completed questionnaires, physical examinations, blood and urine samples, and 5-min HRV indices (including SD of all normal to normal intervals (SDNN), root mean square successive difference (rMSSD), low frequency (LF), high frequency (HF) and their ratio (LF/HF), and total power) obtained from 3-channel Holter monitor. 12 urinary PAH metabolites were measured by gas chromatography-mass spectrometry. FRS was calculated by age, sex, lipid profiles, blood pressure, diabetes and smoking status. Linear regression models were constructed after adjusting for potential confounders.
  
  
  RESULTS
  Elevated total concentration of hydroxynaphthalene (ΣOHNa) was significantly associated, in a dose-responsive manner, with decreased SDNN and LF/HF (ptrend=0.014 and 0.007, respectively); elevated total concentration of hydroxyfluorene (ΣOHFlu) was significantly associated with reduced SDNN, LF and LF/HF (ptrend=0.027, 0.003, and <0.0001, respectively); and elevated total concentration of all PAH metabolites (ΣOH-PAHs) was associated with decreased LF and LF/HF (ptrend=0.005 and <0.0001, respectively). Moreover, increasing quartiles of FRS were significantly associated with decreased HRV indices, except LF/HF (all ptrend<0.0001). Interestingly, individuals in low-risk subgroups had greater decreases in SDNN, LF and LF/HF in relation to ΣOH-PAHs, ΣOHNa and ΣOHFlu than those in high-risk subgroups (all p<0.05).
  
  
  CONCLUSIONS
  Environmental PAH exposure may differentially affect HRV based on individual coronary risk profiles.
authors.affiliation: Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Yingying
authors.initials: Y
authors.lastname: Feng
authors.forename: Huizhen
authors.initials: H
authors.lastname: Sun
authors.forename: Yuanchao
authors.initials: Y
authors.lastname: Song
authors.forename: Junzhe
authors.initials: J
authors.lastname: Bao
authors.forename: Xiji
authors.initials: X
authors.lastname: Huang
authors.forename: Jian
authors.initials: J
authors.lastname: Ye
authors.forename: Jing
authors.initials: J
authors.lastname: Yuan
authors.forename: Weihong
authors.initials: W
authors.lastname: Chen
authors.forename: David C
authors.initials: DC
authors.lastname: Christiani
authors.forename: Tangchun
authors.initials: T
authors.lastname: Wu
authors.forename: Xiaomin
authors.initials: X
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000393:Air Pollutants / Q000009:adverse effects* / Q000494:pharmacology / Q000652:urine; D002318:Cardiovascular Diseases / Q000209:etiology / Q000503:physiopathology; D002681:China; D004305:Dose-Response Relationship, Drug; D015716:Electrocardiography, Ambulatory; D004781:Environmental Exposure / Q000009:adverse effects* / Q000032:analysis; D005260:Female; D005449:Fluorenes / Q000009:adverse effects / Q000494:pharmacology / Q000652:urine; D006321:Heart / Q000187:drug effects* / Q000503:physiopathology; D006339:Heart Rate / Q000187:drug effects*; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009281:Naphthalenes / Q000009:adverse effects / Q000494:pharmacology / Q000652:urine; D011084:Polycyclic Aromatic Hydrocarbons / Q000009:adverse effects* / Q000494:pharmacology / Q000652:urine; D012111:Residence Characteristics; D012307:Risk Factors
chemical_list: D000393:Air Pollutants; D005449:Fluorenes; D009281:Naphthalenes; D011084:Polycyclic Aromatic Hydrocarbons
keywords: Framingham risk score; heart rate variability