Machine Learning-Driven Metabolic Syndrome Prediction: An International Cohort Validation Study

<b>Background/Objectives:</b> This study aimed to develop and validate a machine learning (ML)-based metabolic syndrome (MetS) risk prediction model. <b>Methods:</b> We examined data from 6155 participants of the China Health and Retirement Longitudinal Study (CHARLS) in 2011. The LASSO regression feature selection identified the best MetS predictors. Nine ML-based algorithms were adopted to build predictive models. The model performance was validated using cohort data from the Korea National Health and Nutrition Examination Survey (KNHANES) (<i>n</i> = 5297), the United Kingdom (UK) Biobank (<i>n</i> = 218,781), and the National Health and Nutrition Examination Survey (NHANES) (<i>n</i> = 2549). <b>Results</b>: The multilayer perceptron (MLP)-based model performed best in the CHARLS cohort (AUC = 0.8908; PRAUC = 0.8073), the logistic model in the KNHANES cohort (AUC = 0.9101, PRAUC = 0.8116), the xgboost model in the UK Biobank cohort (AUC = 0.8556, PRAUC = 0.6246), and the MLP model in the NHANES cohort (AUC = 0.9055, PRAUC = 0.8264). <b>Conclusions:</b> Our MLP-based model has the potential to serve as a clinical application for detecting MetS in different populations.