Background: Epidemiological 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. Objectives: The purpose of this study was to examine the potential association between urinary metals and HRV among residents of an urban community in Wuhan, China. Methods: We 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. Results: After adjusting for other metals, creatinine, and other covariates, natural log-transformed urine titanium concentration was positively associated with all HRV indices (all p 52), current smokers (vs. nonsmokers), body mass index < 25 kg/m2 (vs. ≥ 25), and among those who were not hypertensive. Conclusions: Urine concentrations of several metals were associated with HRV parameters in our cross-sectional study population. These findings need replication in other studies with adequate sample sizes. Citation Feng W, He X, Chen M, Deng S, Qiu G, Li X, Liu C, Li J, Deng Q, Huang S, Wang T, Dai X, Yang B, Yuan J, He M, Zhang X, Chen W, Kan H, Wu T. 2015. Urinary metals and heart rate variability: a cross-sectional study of urban adults in Wuhan, China. Environ Health Perspect 123:217–222; http://dx.doi.org/10.1289/ehp.130756
