Effects of Physical Activity, Metabolic Syndrome, and Social Status on ECG Parameters in Children: A Prospective Cohort Study

(1) Background: Physical activity, altered metabolic parameters, and socio-economic status may affect electrocardiographic (ECG) parameters in children. However, a direct comparison of their effects on resting ECG has not yet been performed. (2) Methods: A total of 139 participants (60 male), aged 10-17 years, were recruited. Resting 1-minute ECG recordings and clinical and laboratory investigations were obtained, while socio-economic status and physical activity were assessed using a questionnaire. Associations between these factors and ECG parameters were analyzed using analysis of covariance (ANCOVA). (3) Results: Age, sex, metabolic syndrome, and physical activity significantly influenced the average RR interval (η² = 0.292, 0.070, 0.078, and 0.070, respectively). Similar effects were observed on the T_end-P interval. The PR, QRS, QTc, and T_peak-T_end intervals were moderately influenced by age (η² = 0.084, 0.056, 0.072, and 0.049, respectively). QTc was additionally affected by sex (η² = 0.060). None of the modifiable factors had any effect on depolarization or repolarization parameters. Socio-economic status had no significant effect on resting ECG. (4) Conclusions: Physical activity exerts similar effects on resting ECG in both sexes, while metabolic syndrome is an independent determinant of several ECG parameters. Further studies are warranted to clarify the clinical relevance of these findings.