Metabolic and Lifestyle Risk Factors

Physical inactivity, low fruit and vegetable intake, alcohol use, and tobacco use did not reach statistical significance in the multivariable analysis. The absence of significant lifestyle associations is attributed to recall bias in self-reported data and the cross-sectional design's inability to capture cumulative long-term exposure. Elevated triglycerides are mechanistically linked to insulin resistance, the central driver of pre-diabetes and type 2 diabetes. Overweight and obesity disrupt adipokine signalling and promote systemic inflammation, directly impairing insulin sensitivity. Aging reduces insulin sensitivity and impairs pancreatic beta-cell function, progressively raising blood glucose. Urban residence was associated with increased odds of both pre-diabetes and undiagnosed diabetes, likely through dietary shifts and sedentary patterns.