Abstract
<jats:sec> <jats:title>Introduction</jats:title> <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> </jats:sec> <jats:sec> <jats:title>Methods</jats:title> <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> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p> Thyroid nodules were identified in 40.3% ( <jats:italic>n</jats:italic> = 14,651) 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. </jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions</jats:title> <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> </jats:sec>