Physical Activity, Sedentary Behavior, Cardiorespiratory Fitness and Metabolic Syndrome in Adolescents: Systematic Review and Meta-Analysis of Observational Evidence

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diabetes mellitus 2 endocrinologydiseases
metabolic syndrome 31 endocrinologydiseases
obesity 2 endocrinologydiseases
type 2 diabetes mellitus 2 endocrinologydiseases

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diabetes mellitus 2948 factors, which, if altered, considerably increase the risk of developing cardiovascular disease and type 2 diabetes mellitus [[1],[2]]. To identify carriers of MetS, at least three of the following must be present: elevated blood
diabetes mellitus 11798 (VO2max) [[41]].MetS was defined as a cluster of risk factors for cardiovascular disease and type 2 diabetes mellitus , which included: a) high blood pressure; b) increased triglycerides; c) reduced high-density lipoprotein
metabolic syndrome 8187 search took place on May 07, 2016. As the search strategy, the following keywords were selected: (“ metabolic syndrome ” OR “metabolic syndrome x” OR “syndrome x”) AND (“physical activity” OR “motor activity”
metabolic syndrome 8215 2016. As the search strategy, the following keywords were selected: (“metabolic syndrome” OR “ metabolic syndrome x” OR “syndrome x”) AND (“physical activity” OR “motor activity” OR “sedentary behavior”
metabolic syndrome 21351 assigned to each study.10.1371/journal.pone.0168503.t001Table 1Studies associating physical activity with metabolic syndrome in adolescents.Study, countrySample (number, gender, age)DesignMetS (criteria and prevalence)Physical
metabolic syndrome 26472 or more criteria.10.1371/journal.pone.0168503.t002Table 2Studies associating sedentary behavior with metabolic syndrome in adolescents.Study, countrySample (number, gender, age)DesignMetS (criteria and prevalence)Sedentary
metabolic syndrome 29527 criteria.10.1371/journal.pone.0168503.t003Table 3Studies associating cardiorespiratory fitness with metabolic syndrome in adolescents.Study, countrySample (number, gender, age)DesignMetS (criteria and prevalence)Cardiorespiratory
metabolic syndrome 42788 4).10.1371/journal.pone.0168503.g002Fig 2Forest plot of the primary and subgroup analysis comparing odds ratios for metabolic syndrome among adolescents with moderate/high levels of physical activity versus low level of physical activity.10.1371/journal.pone.0168503.g003Fig
metabolic syndrome 43023 activity.10.1371/journal.pone.0168503.g003Fig 3Forest plot of the primary and subgroup analysis comparing odds ratios for metabolic syndrome among adolescents with low screen time versus high screen time.10.1371/journal.pone.0168503.g004Fig
metabolic syndrome 43218 time.10.1371/journal.pone.0168503.g004Fig 4Forest plot of the primary and subgroup analysis comparing odds ratios for metabolic syndrome among adolescents with moderate/high cardiorespiratory fitness versus low cardiorespiratory fitness.For
metabolic syndrome 61064 limitation. Only one analysis was carried out with ≥ 10 studies (primary analysis, the odds ratio for metabolic syndrome in adolescents with moderate/high levels of physical activity versus low levels of physical activity),
metabolic syndrome 64730 risk.Supporting InformationS1 FigForest plot of the sensitivity analysis comparing odds ratios for metabolic syndrome among adolescents with moderate/high levels of physical activity versus low level of physical activity.(PNG)Click
metabolic syndrome 64965 here for additional data file.S2 FigForest plot of the sensitivity analysis comparing odds ratios for metabolic syndrome among adolescents with low screen time versus high screen time.(PNG)Click here for additional data file.S3
metabolic syndrome 65160 here for additional data file.S3 FigForest plot of the sensitivity analysis comparing odds ratios for metabolic syndrome among adolescents with moderate/high cardiorespiratory fitness versus low cardiorespiratory fitness.(PNG)Click
metabolic syndrome 65395 for additional data file.S4 FigForest plot of the subgroup analysis comparing crude odds ratios for metabolic syndrome among adolescents with moderate/high levels of physical activity versus low levels of physical activity.(PNG)Click
metabolic syndrome 65634 for additional data file.S5 FigForest plot of the subgroup analysis comparing crude odds ratios for metabolic syndrome among adolescents with low screen time versus high screen time.(PNG)Click here for additional data file.S6
metabolic syndrome 65832 for additional data file.S6 FigForest plot of the subgroup analysis comparing crude odds ratios for metabolic syndrome among adolescents with moderate/high cardiorespiratory fitness versus low cardiorespiratory fitness.(PNG)Click
metabolic syndrome 66069 for additional data file.S7 FigForest plot of the subgroup analysis comparing adjusted odds ratio for metabolic syndrome among adolescents with moderate/high levels of physical activity versus low levels of physical activity.(PNG)Click
metabolic syndrome 66311 additional data file.S8 FigForest plot of the subgroup analysis comparing adjusted odds ratios for metabolic syndrome among adolescents with low screen time versus high screen time.(PNG)Click here for additional data file.S9
metabolic syndrome 66512 additional data file.S9 FigForest plot of the subgroup analysis comparing adjusted odds ratios for metabolic syndrome among adolescents with moderate/high cardiorespiratory fitness versus low cardiorespiratory fitness.(PNG)Click
metabolic syndrome 66736 fitness.(PNG)Click here for additional data file.S10 FigForest plot of the subgroup analysis (high prevalence of metabolic syndrome vs. low prevalence) comparing odds ratios for metabolic syndrome among adolescents with moderate/high
metabolic syndrome 66801 subgroup analysis (high prevalence of metabolic syndrome vs. low prevalence) comparing odds ratios for metabolic syndrome among adolescents with moderate/high levels of physical activity versus low levels of physical activity.(PNG)Click
metabolic syndrome 67029 activity.(PNG)Click here for additional data file.S11 FigForest plot of the subgroup analysis (high prevalence of metabolic syndrome vs. low prevalence) comparing odds ratios for metabolic syndrome among adolescents with low screen time
metabolic syndrome 67094 subgroup analysis (high prevalence of metabolic syndrome vs. low prevalence) comparing odds ratios for metabolic syndrome among adolescents with low screen time versus high screen time.(PNG)Click here for additional data file.S12
metabolic syndrome 67281 time.(PNG)Click here for additional data file.S12 FigForest plot of the subgroup analysis (high prevalence of metabolic syndrome vs. low prevalence) comparing odds ratios for metabolic syndrome among adolescents with moderate/high
metabolic syndrome 67346 subgroup analysis (high prevalence of metabolic syndrome vs. low prevalence) comparing odds ratios for metabolic syndrome among adolescents with moderate/high cardiorespiratory fitness versus low cardiorespiratory fitness.(PNG)Click
metabolic syndrome 67598 data file.S13 FigForest plot of the subgroup analysis (according to the criteria used to diagnose the metabolic syndrome ) comparing odds ratios for metabolic syndrome among adolescents with moderate/high levels of physical
metabolic syndrome 67644 analysis (according to the criteria used to diagnose the metabolic syndrome) comparing odds ratios for metabolic syndrome among adolescents with moderate/high levels of physical activity versus low levels of physical activity.(PNG)Click
metabolic syndrome 67900 data file.S14 FigForest plot of the subgroup analysis (according to the criteria used to diagnose the metabolic syndrome ) comparing odds ratios for metabolic syndrome among adolescents with low screen time versus high screen
metabolic syndrome 67946 analysis (according to the criteria used to diagnose the metabolic syndrome) comparing odds ratios for metabolic syndrome among adolescents with low screen time versus high screen time.(PNG)Click here for additional data file.S15
metabolic syndrome 68161 data file.S15 FigForest plot of the subgroup analysis (according to the criteria used to diagnose the metabolic syndrome ) comparing odds ratios for metabolic syndrome among adolescents with moderate/high cardiorespiratory
metabolic syndrome 68207 analysis (according to the criteria used to diagnose the metabolic syndrome) comparing odds ratios for metabolic syndrome among adolescents with moderate/high cardiorespiratory fitness versus low cardiorespiratory fitness.(PNG)Click
metabolic syndrome 68436 here for additional data file.S16 FigFunnel plot of the primary analysis comparing odds ratios for metabolic syndrome among adolescents with moderate/high levels of physical activity versus low level of physical activity.(PNG)Click
obesity 11988 reduced high-density lipoprotein cholesterol (HDL-c); d) impaired fasting glucose; and e) abdominal obesity [[3],[4]]. The factors were considered independently of the cut-off points established for each of them,
obesity 12712 by the International Diabetes Federation (IDF) [[48]], considers the mandatory presence of abdominal obesity and any other two factors.Some studies [[8],[13],[15],[17],[18],[20],[26]] identify MetS using two or
type 2 diabetes mellitus 2941 factors, which, if altered, considerably increase the risk of developing cardiovascular disease and type 2 diabetes mellitus [[1],[2]]. To identify carriers of MetS, at least three of the following must be present: elevated blood
type 2 diabetes mellitus 11791 uptake (VO2max) [[41]].MetS was defined as a cluster of risk factors for cardiovascular disease and type 2 diabetes mellitus , which included: a) high blood pressure; b) increased triglycerides; c) reduced high-density lipoprotein

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