Abstract
BACKGROUND: Health disparities and glycemic risk among tribal and non-tribal populations in India remain poorly characterized particularly in the context of socio-demographic, behavioral, cultural, and clinical aspects. This study aimed to comprehensively assess various health parameters and to evaluate clinical predictors associated with cardiovascular burden to assess glycemic status in tribal and non-tribal adults. METHODS: We conducted a community-based cross-sectional study across 33 districts of Gujarat and Madhya Pradesh. Participants were stratified by sex and age. Anthropometric measurements, blood pressure, and biochemical parameters including HbA1c, lipid profile, liver and renal function tests, and micronutrients were assessed. For comparison between groups non-parametric Mann-Whitney U-test and chi-square analysis was done. Multinomial logistic regression was applied to identified associations between clinical indicators and glycemic status. ROC curves was used to evaluate predictive accuracy of clinical indicators. RESULTS: Among 1,720 participants, significant socio-demographic and behavioral differences were noted, with notably higher illiteracy rates (47.6%) and increased tobacco (30.3%) and alcohol consumption (8.4%) among tribal populations (all p < 0.001). Tribal individuals reflect considerably lower anthropometric measurements, blood pressure, fasting glucose, HbA1c, total cholesterol (TC), triglycerides (TG), and LDL cholesterol (all p < 0.05), as well as reduced hemoglobin levels but elevated red blood cell counts and eosinophils (p < 0.001), indicating a unique metabolic-hematologic profile. Further, multinomial regression analysis shown age as the significant predictor of dysglycemia in both groups, with increased odds of diabetic HbA1c levels in older tribal participants (OR = 5.830, p = 0.005) and non-tribal (OR = 28.252, p < 0.001); systolic hypertension was an independent predictor of diabetic HbA1c among tribal individuals (OR = 5.530, p = 0.015), while obesity (OR = 3.652, p < 0.001) and hypertriglyceridemia (OR = 4.690, p < 0.001) were notable correlates in non-tribal individuals. ROC analysis indicated acceptable predictive accuracy of age for glycemic risk i.e., diabetic HbA1c level (AUC = 0.687 tribal; 0.763 non-tribal) and systolic blood pressure (AUC = 0.725 tribal; 0.664 non-tribal). CONCLUSION: Tribal and non-tribal populations exhibit distinct sex- and age-specific health patterns, reflecting the coexistence of persistent undernutrition and an ongoing cardiovascular transition. These observations highlight the importance of developing population-specific, age-stratified screening frameworks and targeted prevention strategies to address emerging metabolic risk across diverse community settings. Such tailored approaches are essential to promote equitable and precision-oriented public health strategies.