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Metabolic Syndrome (MetS) is a cluster of interrelated risk factors that significantly increases the risk of cardiovascular diseases and type 2 diabetes. Despite its global prevalence, accurate prediction of MetS remains challenging due to issues such as class imbalance, data scarcity, and methodological inconsistencies in existing studies. In this paper, we address these challenges by systematically evaluating and optimizing machine learning (ML) models for MetS prediction, leveraging advanced data balancing techniques and counterfactual analysis. Multiple ML models, including XGBoost, Random Forest, TabNet, etc., were trained and compared under various data balancing techniques such as random oversampling (ROS), SMOTE, ADASYN, and CTGAN. Additionally, we introduce MetaBoost, a novel hybrid framework that integrates SMOTE, ADASYN, and CTGAN, optimizing synthetic data generation through weighted averaging and iterative weight tuning to enhance the model's performance (achieving up to a 1.87% accuracy improvement over individual balancing techniques). A comprehensive counterfactual analysis is conducted to quantify the feature-level changes required to shift individuals from high-risk to low-risk categories. The results indicate that blood glucose (50.3%) and triglycerides (46.7%) were the most frequently modified features, highlighting their clinical significance in MetS risk reduction. Additionally, probabilistic analysis shows elevated blood glucose (85.5% likelihood) and triglycerides (74.9% posterior probability) as the strongest predictors. This study not only advances the methodological rigor of MetS prediction but also provides actionable insights for clinicians and researchers, highlighting the potential of ML in mitigating the public health burden of metabolic syndrome.

Detecting Type 2 Diabetes (T2D) and Prediabetes (PD) is a real challenge for medicine due to the absence of pathogenic symptoms and the lack of known associated risk factors. Even though some proposals for machine learning models enable the identification of people at risk, the nature of the condition makes it so that a model suitable for one population may not necessarily be suitable for another. In this article, the development and assessment of predictive models to identify people at risk for T2D and PD specifically in Argentina are discussed. First, the database was thoroughly preprocessed and three specific datasets were generated considering a compromise between the number of records and the amount of available variables. After applying 5 different classification models, the results obtained show that a very good performance was observed for two datasets with some of these models. In particular, RF, DT, and ANN demonstrated great classification power, with good values for the metrics under consideration. Given the lack of this type of tool in Argentina, this work represents the first step towards the development of more sophisticated models.