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Background:Exposure to metals might be a risk factor for hypertension, which contributes largely to the global burden of disease and mortality. However, relevant epidemiological studies of associations between metals exposure with hypertension among preschoolers are limited. This study aimed to explore the associations of urine metals with blood pressure and hypertension among Chinese preschoolers.Methods: A total of 1220 eligible participants who had urine metals measurement, blood pressure measurements, and relevant covariates were included in this cross-sectional study. Urine concentrations of metals were measured by inductively coupled plasma mass spectrometer. The single and multiple metals regression models were used to investigate the associations of urine metal with blood pressure and the risk of hypertension after adjusting for potential confounders. Results: We observed urine concentrations of chromium, iron, and barium were negatively associated with levels of systolic blood pressure, diastolic blood pressure and the risk of hypertension in the single metal model (all P-FDR adjustment < 0.05). Significant associations of urine chromium concentrations with systolic blood pressure, diastolic blood pressure and the risk of hypertension were found in the multi-metal model ((β or odds ratio (95% confidence interval) was -3.07 (-5.12, -1.02) , -2.25 (-4.29, -0.22), and 0.51 (0.26, 0.97) for 3rd quartile, compared with 1st quartile, respectively). The same association was found for barium concentrations in the multi-metal model, while none of the associations among iron quartiles was significant. In addition, urine chromium, iron and barium may have joint effects on levels of systolic blood pressure and diastolic blood pressure and risk of hypertension. Children’s age and body mass index could modify the associations of chromium, iron, and barium concentrations with blood pressure.Conclusions: Our findings suggested that exposure to chromium, iron, and barium was inversely associated with blood pressure and hypertension among preschool children. These findings need further validation in prospective studies.

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Heavy metal exposure has been widely recognized as a risk factor for human health. However, epidemiological studies of associations between exposure to metal mixtures with bone strength among preschoolers are limited. We estimated the associations of 23 urinary metals with the risk of insufficient bone strength (IBS) among 1399 children aged 2–6 years in China. Urine concentrations of 23 metals were measured using inductively coupled plasma mass spectrometer and bone strength was measured using the quantitative ultrasound instrument. The weighted quantile sum (WQS) and bayesian kernel machine regression (BKMR) models were conducted to investigate the associations between exposure to metal mixtures and IBS. In the single metal exposure model, urine cobalt and zinc were identified to be negatively associated with IBS, whereas urine lead was positively associated with IBS. Furthermore, WQS regression and BKMR analyses consistently showed that exposure to metal mixtures was inversely related to IBS, and cobalt was the main contributor to the combined effects. Such associations were more evident in children aged 2–4 years. These findings indicated that exposure to metal mixtures was associated with bone strength among children. These findings need further validation in prospective studies.