{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T04:58:56Z","timestamp":1780894736493,"version":"3.54.1"},"reference-count":36,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T00:00:00Z","timestamp":1780876800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Mongolia faces rising rates of obesity, diabetes, and cardiovascular disease, yet little is known about their relationship with thyroid nodules. This study aimed to assess the prevalence of thyroid nodules and their association with cardiometabolic outcomes in the Mongolian population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A nationwide retrospective analysis was conducted among 36,395 adults who underwent thyroid ultrasound during routine health checkups. Demographic, anthropometric, and metabolic parameters were recorded, including body mass index (BMI), central obesity, blood pressure, diabetes, and cardiovascular risk based on WHO criteria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Thyroid nodules were identified in 40.3% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200914,651) of participants. Age-adjusted prevalence was 32.1% overall, 19.8% in men, and 39.2% in women, with higher rates in Ulaanbaatar (43.9%) than in rural areas (35.4%). Participants with nodules had higher BMI, central obesity, diabetes, and cardiovascular risk compared to those without nodules. Prevalence was greatest in the very high CVD risk category (60.0% in women, 33.1% in men). Multivariate models confirmed independent associations between thyroid nodules and age, female sex, obesity, and cardiovascular risk.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Thyroid nodules are highly prevalent in Mongolia and cluster with adverse cardiometabolic outcomes. Nodules may serve as a clinical marker of elevated cardiovascular risk. Future longitudinal studies should explore potential bidirectional pathways between obesity, thyroid nodules, and cardiometabolic disease.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcvm.2026.1762003","type":"journal-article","created":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T04:23:53Z","timestamp":1780892633000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["High prevalence of thyroid nodules and their association with cardiometabolic risk in Mongolia"],"prefix":"10.3389","volume":"13","author":[{"given":"Oyuntugs","family":"Byambasukh","sequence":"first","affiliation":[{"name":"Department of Endocrinology, School of Medicine, Mongolian National University of Medical Sciences","place":["Ulaanbaatar, Mongolia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anar","family":"Bayarmunkh","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, School of Medicine, Mongolian National University of Medical Sciences","place":["Ulaanbaatar, Mongolia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsakhim-Erdene","family":"Tsendjav","sequence":"additional","affiliation":[{"name":"Department of Radiology, School of Medicine, Mongolian National University of Medical Sciences","place":["Ulaanbaatar, Mongolia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tugsjargal","family":"Purevsukh","sequence":"additional","affiliation":[{"name":"Department of Radiology, School of Medicine, Mongolian National University of Medical Sciences","place":["Ulaanbaatar, Mongolia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tuvshinjargal","family":"Dashjamts","sequence":"additional","affiliation":[{"name":"Department of Radiology, School of Medicine, Mongolian National University of Medical Sciences","place":["Ulaanbaatar, Mongolia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Batzorig","family":"Bayartsogt","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, School of Public Health, Mongolian National University of Medical Sciences","place":["Ulaanbaatar, Mongolia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enkhtur","family":"Yadamsuren","sequence":"additional","affiliation":[{"name":"Mongolian National University of Medical Sciences","place":["Ulaanbaatar, Mongolia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Altaisaikhan","family":"Khasag","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, School of Medicine, Mongolian National University of Medical Sciences","place":["Ulaanbaatar, Mongolia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oyunsuren","family":"Enebish","sequence":"additional","affiliation":[{"name":"Ministry of Health of Mongolia","place":["Ulaanbaatar, Mongolia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tumur-Ochir","family":"Tsedev-Ochir","sequence":"additional","affiliation":[{"name":"State Central Third Hospital","place":["Ulaanbaatar, Mongolia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,8]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"699","DOI":"10.1111\/j.1365-2362.2009.02162.x","article-title":"Very high prevalence of thyroid nodules detected by high frequency (13 MHz) ultrasound examination","volume":"39","author":"Guth","year":"2009","journal-title":"Eur J Clin Invest"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1","DOI":"10.4158\/EP161208.GL","article-title":"American association of clinical endocrinologists, American college of endocrinology, and associazione medici endocrinologi medical guidelines for clinical practice for the diagnosis and management of thyroid nodules\u20132016 update","volume":"22","author":"Gharib","year":"2016","journal-title":"Endocr Pract"},{"key":"B3","doi-asserted-by":"publisher","first-page":"680250","DOI":"10.3389\/fendo.2021.730279","article-title":"Correlation between thyroid nodules and metabolic syndrome: a systematic review and meta-analysis","volume":"12","author":"Zhang","year":"2021","journal-title":"Front Endocrinol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"599","DOI":"10.1530\/EJE-09-0410","article-title":"Metabolic syndrome and its components are associated with increased thyroid volume and nodule prevalence in a mild-to-moderate iodine-deficient area","volume":"161","author":"Ayturk","year":"2009","journal-title":"Eur J Endocrinol"},{"key":"B5","doi-asserted-by":"publisher","first-page":"753","DOI":"10.3904\/kjim.2015.273","article-title":"Prevalence of thyroid nodules and their associated clinical parameters: a large-scale, multicenter-based health checkup study","volume":"33","author":"Moon","year":"2016","journal-title":"Korean J Intern Med"},{"key":"B6","doi-asserted-by":"publisher","first-page":"656084","DOI":"10.3389\/fendo.2021.736972","article-title":"The relationship and gender disparity between thyroid nodules and metabolic syndrome components based on a recent nationwide cross-sectional study and meta-analysis","volume":"12","author":"Zhang","year":"2021","journal-title":"Front Endocrinol"},{"key":"B7","doi-asserted-by":"publisher","first-page":"175","DOI":"10.1530\/EC-20-0398","article-title":"An analysis of the correlation between thyroid nodules and metabolic syndrome","volume":"12","author":"Liu","year":"2019","journal-title":"Diabetes Metab Syndr Obes"},{"key":"B8","doi-asserted-by":"publisher","first-page":"247","DOI":"10.2147\/DMSO.S219019","article-title":"Correlation analysis of metabolic syndrome and its components with thyroid nodules","volume":"9","author":"Hu","year":"2020","journal-title":"Endocr Connect"},{"key":"B9","doi-asserted-by":"publisher","first-page":"2207","DOI":"10.1210\/jc.2016-3842","article-title":"Risk of thyroid nodules in residents of Belarus exposed to chernobyl fallout as children and adolescents.","volume":"102","author":"Cahoon","year":"2017","journal-title":"J Clin Endocrinol Metab"},{"key":"B10","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12902-021-00842-2","article-title":"Prevalence and associated metabolic factors for thyroid nodules: a cross-sectional study in Southwest of China with more than 120 thousand populations","volume":"21","author":"Xu","year":"2021","journal-title":"BMC Endocr Disord"},{"key":"B11","doi-asserted-by":"publisher","first-page":"132","DOI":"10.3904\/kjim.2015.273","article-title":"Prevalence of thyroid nodules and their associated clinical parameters: a large-scale, multicenter-based health checkup study","volume":"21","author":"Xu","year":"2021","journal-title":"BMC Endocr Disord"},{"key":"B12","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12902-018-0232-8","article-title":"Association of thyroid nodules with adiposity: a community-based cross-sectional study in China","volume":"18","author":"Song","year":"2018","journal-title":"BMC Endocr Disord"},{"key":"B13","doi-asserted-by":"publisher","first-page":"970","DOI":"10.1016\/j.metabol.2013.01.009","article-title":"Impaired glucose metabolism is a risk factor for increased thyroid volume and nodule prevalence in a mild-to-moderate iodine deficient area","volume":"62","author":"Anil","year":"2013","journal-title":"Metab Clin Exp"},{"key":"B14","doi-asserted-by":"publisher","first-page":"230","DOI":"10.1007\/s12020-013-9968-0","article-title":"The prevalence of thyroid nodules and its relationship with metabolic parameters in a Chinese community-based population aged over 40 years","volume":"45","author":"Guo","year":"2014","journal-title":"Endocrine"},{"key":"B15","doi-asserted-by":"publisher","first-page":"339","DOI":"10.1007\/s12020-017-1394-2","article-title":"Association of obesity and diabetes with thyroid nodules","volume":"60","author":"Buscemi","year":"2018","journal-title":"Endocrine"},{"key":"B16","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2017\/8401518","article-title":"Factors associated with the prevalence of thyroid nodules and goiter in middle-aged euthyroid subjects","volume":"2017","author":"Dauksiene","year":"2017","journal-title":"Int J Endocrinol"},{"key":"B17","doi-asserted-by":"publisher","first-page":"120","DOI":"10.1590\/S0004-27302013000200004","article-title":"Prevalence of goiter and thyroid nodular disease in patients with class III obesity","volume":"57","author":"Sousa","year":"2013","journal-title":"Arq Bras Endocrinol Metabol"},{"key":"B18","doi-asserted-by":"publisher","first-page":"98","DOI":"10.3904\/kjim.2016.31.1.98","article-title":"Relationship between metabolic syndrome and thyroid nodules in healthy Koreans","volume":"31","author":"Shin","year":"2016","journal-title":"Korean J Intern Med"},{"key":"B19","doi-asserted-by":"publisher","first-page":"560","DOI":"10.1007\/s12020-017-1285-6","article-title":"Association between lifestyle and anthropometric parameters and thyroid nodule features","volume":"56","author":"Panagiotou","year":"2017","journal-title":"Endocrine"},{"key":"B20","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1186\/s12889-021-12070-3","article-title":"Mongolia health situation: based on the global burden of disease study 2019","volume":"22","author":"Chimed-Ochir","year":"2022","journal-title":"BMC Public Health"},{"key":"B21","doi-asserted-by":"publisher","first-page":"1447","DOI":"10.18502\/ijph.v52i7.13246","article-title":"Trends in behavioral and biological non-communicable diseases risk factors among adults in Mongolia: results from national cross-sectional surveys in 2005, 2009, 2013 and 2019","volume":"52","author":"Pengpid","year":"2023","journal-title":"Iran J Public Health"},{"key":"B22","doi-asserted-by":"publisher","first-page":"102375","DOI":"10.1016\/j.dsx.2021.102375","article-title":"National trends in metabolic syndrome among adults in Mongolia from three cross-sectional surveys in 2009, 2013, and 2019","volume":"16","author":"Pengpid","year":"2022","journal-title":"Diabetes Metab Syndr"},{"key":"B23","year":"2017"},{"key":"B24","doi-asserted-by":"publisher","first-page":"1222","DOI":"10.3390\/healthcare12121222","article-title":"Examining age-adjusted associations between BMI and comorbidities in Mongolia: cross-sectional prevalence","volume":"12","author":"Enkhtugs","year":"2024","journal-title":"Healthcare"},{"key":"B25","doi-asserted-by":"publisher","first-page":"T273","DOI":"10.1530\/ERC-14-0053","article-title":"Estrogen and its role in thyroid cancer","volume":"21","author":"Derwahl","year":"2014","journal-title":"Endocr Relat Cancer"},{"key":"B26","doi-asserted-by":"publisher","first-page":"615","DOI":"10.1507\/endocrj.K10E-024","article-title":"The relationship between thyroid nodules and uterine fibroids","volume":"57","author":"Kim","year":"2010","journal-title":"Endocr J"},{"key":"B27","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1016\/j.jtbi.2014.12.015","article-title":"Thyroid autoimmunity as a window to autoimmunity: an explanation for sex differences in the prevalence of thyroid autoimmunity","volume":"375","author":"Merrill","year":"2015","journal-title":"J Theor Biol"},{"key":"B28","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1016\/bs.vh.2017.07.001","article-title":"Thyroid autoimmunity: an interplay of factors","volume":"106","author":"Merrill","year":"2018","journal-title":"Vitam Horm"},{"key":"B29","doi-asserted-by":"publisher","first-page":"755","DOI":"10.1089\/thy.2010.1636","article-title":"Environmental exposures and autoimmune thyroid disease","volume":"20","author":"Brent","year":"2010","journal-title":"Thyroid"},{"key":"B30","doi-asserted-by":"publisher","first-page":"703","DOI":"10.1016\/S2213-8587(20)30129-7","article-title":"Endocrine-disrupting chemicals: implications for human health","volume":"8","author":"Kahn","year":"2020","journal-title":"Lancet Diabetes Endocrinol"},{"key":"B31","doi-asserted-by":"publisher","first-page":"265","DOI":"10.1007\/978-3-030-85357-0_14","article-title":"Exposure to endocrine disrupting chemicals, part of lifestyle factors related to growth disorders in childhood and chronic diseases in adulthood","volume":"3","author":"Hemati","year":"2022","journal-title":"Healthy Lifestyle"},{"key":"B32","doi-asserted-by":"publisher","first-page":"108562","DOI":"10.1016\/j.reprotox.2024.108562","article-title":"Endocrine-disrupting chemicals and hormonal profiles in PCOS women: a comparative study between urban and rural environment","volume":"125","author":"Patel","year":"2024","journal-title":"Reprod Toxicol"},{"key":"B33","doi-asserted-by":"publisher","first-page":"442","DOI":"10.3390\/ijerph13040442","article-title":"The prevalence of thyroid nodules and an analysis of related lifestyle factors in Beijing communities","volume":"13","author":"Jiang","year":"2016","journal-title":"Int J Environ Res Public Health"},{"key":"B34","doi-asserted-by":"publisher","first-page":"571","DOI":"10.1007\/s11523-017-0514-5","article-title":"Insulin-like growth factor (IGF) pathway targeting in cancer: role of the IGF axis and opportunities for future combination studies","volume":"12","author":"Simpson","year":"2017","journal-title":"Target Oncol"},{"key":"B35","doi-asserted-by":"publisher","first-page":"1292","DOI":"10.3390\/life13061292","article-title":"Thyroid nodules and obesity","volume":"13","author":"Demetriou","year":"2023","journal-title":"Life"},{"key":"B36","doi-asserted-by":"publisher","first-page":"113","DOI":"10.1017\/S0029665122002762","article-title":"The remarkable impact of iodisation programmes on global public health.","volume":"82","author":"Zimmermann","year":"2023","journal-title":"Proc Nutr Soc"}],"container-title":["Frontiers in Cardiovascular Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2026.1762003\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T04:23:54Z","timestamp":1780892634000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2026.1762003\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,8]]},"references-count":36,"alternative-id":["10.3389\/fcvm.2026.1762003"],"URL":"https:\/\/doi.org\/10.3389\/fcvm.2026.1762003","relation":{},"ISSN":["2297-055X"],"issn-type":[{"value":"2297-055X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,8]]},"article-number":"1762003"}}