Identify the Characteristics of Metabolic Syndrome and Non-obese Phenotype: Data Visualization and a Machine Learning Approach.

A third of the world's population is classified as having Metabolic Syndrome (MetS). Traditional diagnostic criteria for MetS are based on three or more of five components. However, the outcomes of patients with different combinations of specific metabolic components are undefined. It is challenging to be discovered and introduce treatment in advance for intervention, since the related research is still insufficient. This retrospective cohort study attempted to establish a method of visualizing metabolic components by using unsupervised machine learning and treemap technology to discover the relations between predicting factors and different metabolic components. Several supervised machine-learning models were used to explore significant predictors of MetS and to construct a powerful prediction model for preventive medicine. The random forest had the best performance with accuracy and c-statistic of 0.947 and 0.921, respectively, and found that body mass index, glycated hemoglobin, and controlled attenuation parameter (CAP) score were the optimal primary predictors of MetS. In treemap, high triglyceride level plus high fasting blood glucose or large waist circumference group had higher CAP scores (>260) than other groups. Moreover, 32.2% of patients with high CAP scores during 3 years of follow-up had metabolic diseases are observed. This reveals that the CAP score may be used for detecting MetS, especially for the non-obese MetS phenotype. Machine learning and data visualization can illustrate the complicated relationships between metabolic components and potential risk factors for MetS.