# Enhancing Metabolic Syndrome Prediction with Hybrid Data Balancing and Counterfactuals

arXiv: https://arxiv.org/abs/2504.06987 · HTML: https://mlsanity.com/paper/2504.06987/

## Key facts

- Cited by 2 papers in the map (data through 14 Oct 2026).
- Builds on 9 of its 37 references that are in the map.
- First posted on arXiv 9 Apr 2025.

## Builds on (most cited first, 9 of 9)

- [XGBoost: A Scalable Tree Boosting System](https://mlsanity.com/paper/1603.02754/) (2016)
- [Counterfactual Explanations without Opening the Black Box: Automated Decisions and the GDPR](https://mlsanity.com/paper/1711.00399/) (2017)
- [Modeling Tabular data using Conditional GAN](https://mlsanity.com/paper/1907.00503/) (2019)
- [TabNet: Attentive Interpretable Tabular Learning](https://mlsanity.com/paper/1908.07442/) (2019)
- [NICE: An Algorithm for Nearest Instance Counterfactual Explanations](https://mlsanity.com/paper/2104.07411/) (2021)
- [Oversampling for Imbalanced Learning Based on K-Means and SMOTE](https://mlsanity.com/paper/1711.00837/) (2017)
- [Use of What-if Scenarios to Help Explain Artificial Intelligence Models for Neonatal Health](https://mlsanity.com/paper/2410.09635/) (2024)
- [Self-Supervised Learning and Opportunistic Inference for Continuous Monitoring of Freezing of Gait in Parkinson's Disease](https://mlsanity.com/paper/2410.21326/) (2024)
- [Freezing of Gait Detection Using Gramian Angular Fields and Federated Learning from Wearable Sensors](https://mlsanity.com/paper/2411.11764/) (2024)

## Built on by (most cited first, 2 of 2)

- [GlyTwin: Digital Twin for Glucose Control in Type 1 Diabetes Through Optimal Behavioral Modifications Using Patient-Centric Counterfactuals](https://mlsanity.com/paper/2504.09846/) (2025)
- [Trustworthy AI in Digital Health: A Comprehensive Review of Robustness and Explainability](https://mlsanity.com/paper/2608.02238/) (2026)

## Abstract (arXiv)

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.