Metabolic syndrome (MetS) is a multimorbid long-term condition without consensual medical definition and a diagnostic based on compatible symptomatology. In conventional medicine,
MetS is diagnosed by the arithmetic addition of elevated risk factors including diabetes, obesity dyslipidemia and hypertension, among others. Here we have investigated the molecular signature of MetS in urine and serum based on NMR metabolomics. Specifically, we investigated a European cohort including urine and serum samples from 11,754 individuals (18-75 years old, 41% females), designed to populate all the intermediate conditions in MetS, from subjects without any risk factor up to individuals with developed MetS (4-5%, depending on the definition). A set of quantified metabolites and liporpoteins were integrated from the urine and/or serum spectra to obtain metabolic models to discriminate between individuals with MetS.