LPL and Insulin resistance: The strong RC-diabetes association (33.6% vs. 27.3%, p = 0.04) unveils a bidirectional metabolic cycle: insulin resistance enhances hepatic VLDL secretion while impairing lipoprotein lipase activity, perpetuating RC accumulation - mechanism supported by NHANES data showing RC-HOMA-IR correlations in MAFLD patients (β = 0.17, p < 0.001 at RC < 30 mg/dL) [23, 26].