Background: Stroke is the second leading cause of death and disability worldwide. According to the World Health Organization report (2018), Mongolia has one of the highest stroke rates in the Western Pacific region and ranks second globally in stroke mortality and first in stroke-related disability. However, studies investigating the prevalence of diabetes mellitus (DM) among stroke patients in Mongolia remain limited. Aim: To determine the prevalence of diabetes mellitus among patients hospitalized due to ischemic stroke and to analyse the distribution of stroke subtypes. Materials and Methods: This retrospective study included patients with ischemic stroke who were admitted to the First and Third Central Hospitals of Mongolia within 24 hours after stroke symptom onset between 2024 and 2025. Data from 292 patients were analyzed. Demographic characteristics, stroke severity, time intervals, and laboratory findings were collected and compared between patients with and without diabetes mellitus. Result: The mean age of the study population was 61.9±12.9 years, and the majority of participants were male. Diabetes mellitus was present in 25% of the patients. The median duration of diabetes was 16 years (range 0–23 years), and the mean HbA1c level was 8.81±2.46%. There were no significant differences between diabetic and non-diabetic patients in terms of age, sex distribution, stroke severity, length of hospital stay, or in-hospital mortality. However, body mass index and glycemic parameters were significantly higher in patients with diabetes (p<0.001). According to the TOAST classification, small vessel disease was the most common stroke subtype, accounting for 57.3% of cases in patients with diabetes and 44.2% in patients without diabetes. Conclusion 1. Diabetes mellitus was present in one out of every four patients hospitalized with ischemic stroke. 2. Atherosclerotic stroke was six times more frequent in patients with diabetes compared with those without diabetes, highlighting the importance of early detection and management of diabetes in stroke prevention.

Background: Diabetes mellitus and disturbances in glucose metabolism are associated with an increased risk of thrombosis through endothelial dysfunction, chronic low-grade inflammation, platelet hyperactivity, and alterations in coagulation factors. Aim: To investigate the association between fasting glucose levels and selected coagulation and platelet parameters. Materials and Methods: This analytical cross-sectional study included 172 participants. According to the exclusion criteria, individuals with previously diagnosed diabetes mellitus, anticoagulant use, or liver disease were excluded. Participants were categorized into two groups according to fasting glucose levels: <5.6 mmol/L and ≥5.6 mmol/L. Activated partial thromboplastin time (aPTT), prothrombin time (PT), international normalized ratio (INR), thrombin time (TT), fibrinogen, platelet count, mean platelet volume (MPV), platelet distribution width (PDW), and plateletcrit (PCT) were compared between the two groups. Between-group differences were assessed using the Mann–Whitney U test, and associations between continuous variables were evaluated using Spearman’s correlation analysis. Multivariable linear regression analysis was adjusted for age, sex, and body mass index (BMI). Result: Of the 172 participants, 145 (84.3%) had fasting glucose levels <5.6 mmol/L and 27 (15.7%) had fasting glucose levels ≥5.6 mmol/L. The median aPTT was significantly shorter in participants with elevated fasting glucose than in those with fasting glucose <5.6 mmol/L (25.4 [24.2–26.8] vs. 26.3 [24.9–27.95] seconds; p=0.029). No statistically significant between-group differences were observed in PT, INR, TT, fibrinogen, platelet count, MPV, PDW, or PCT. A weak inverse correlation was observed between fasting glucose and aPTT (ρ=−0.141). In multivariable regression analysis adjusted for age, sex, and BMI, each 1 mmol/L increase in fasting glucose was associated with a 0.242-second decrease in aPTT (B=−0.242; 95% CI, −0.465 to −0.020; p=0.033). Conclusion 1. The median aPTT was significantly shorter in participants with elevated fasting glucose than in those without elevated fasting glucose. 2. Each 1 mmol/L increase in fasting glucose was associated with a 0.242-second decrease in aPTT.

Background: High-resolution esophageal manometry (HREM) is the reference standard for the assessment of esophageal motor function and classification of esophageal motility disorders. HREM was introduced into clinical practice in Mongolia in 2022; however, the spectrum of manometric diagnoses and factors associated with major esophageal motility disorders in this population have not been systematically characterized. Aim: To characterize major esophageal motility disorders among adults undergoing HREM and to identify clinical factors independently associated with these disorders. Materials and Methods: This retrospective observational study included 1,033 adults who underwent HREM at Intermed Hospital between September 2022 and March 2026. Manometric studies were interpreted according to the Chicago Classification version 4.0 (CCv4.0). Major esophageal motility disorders were defined as achalasia, manometric esophagogastric junction outflow obstruction (EGJOO), distal esophageal spasm, hypercontractile esophagus, and absent contractility. Multivariable logistic regression was used to identify factors independently associated with major motility disorders. Result: Major esophageal motility disorders were identified in 112 patients (11.2%). Compared with patients with normal motility or ineffective esophageal motility, those with major motility disorders had a significantly lower mean body mass index (BMI) (24.7±4.9 vs. 27.5±4.2 kg/m; p<0.001) and a higher prevalence of dysphagia (50.5% vs. 21.3%; p<0.001) and referral for suspected esophageal motility disorders (70.5% vs. 25.2%; p<0.001). In multivariable analysis, older age per 10-year increment (adjusted odds ratio [aOR], 1.35; 95% confidence interval [CI], 1.12–1.61), lower BMI (aOR per 1-kg/m increase, 0.90; 95% CI, 0.85–0.95), dysphagia (aOR, 1.95; 95% CI, 1.20–3.15), and referral for suspected motility disorders (aOR, 5.47; 95% CI, 3.22–9.31) were independently associated with major esophageal motility disorders. Conclusion 1. Major esophageal motility disorders were identified in 11.2% of adults undergoing HREM in this clinical cohort. 2. Referral for suspected motility disorders was the strongest clinical correlate, while older age, lower BMI, and dysphagia were also independently associated with major motility disorders.

Background: Depression, anxiety, and stress related to diabetes create psychosocial distress. In Mongolia, although the prevalence of diabetes has been rapidly increasing in recent years, studies on psychosocial and mental health–related clinical factors among people with diabetes are limited. To study some psychosocial and mental health–related changes occurring in people with diabetes in relation to disease complications and control indicators. Materials and Methods: The study was conducted using an analytical cross-sectional design, including 172 adults with diabetes. Standard assessment tools such as the Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, and Diabetes Distress Scale questionnaires were used to collect data. Cases that tested positive on two or more instruments were defined as having “composite psychosocial distress.” Univariate and multivariate logistic regression analyses were performed to identify factors associated with composite psychosocial distress, and additional statistical models were developed for each outcome. Result: The mean age of participants was 58.3±10.4 years, and 57.6% were female. The mean HbA1c value was 9.0% (IQR 7.5–11.0), and the average duration of diabetes was 10 years (IQR 6–16). Among all participants, 16.9% had composite psychosocial distress. One chronic complication related to diabetes was observed in 47.7% of participants, while 17.0% had two or more complications. Scores of depression, anxiety, and diabetes-related distress were positively correlated (all p<0.001). In univariate analysis, with each additional chronic complication, composite psychosocial distress increased (OR=1.93, 95% CI 1.31–2.87; p=0.001). In univariate regression analysis, higher HbA1c significantly increased the risk of composite psychosocial distress (for each 1% increase, OR=1.14, 95% CI 1.01–1.28; p=0.040). In multivariate analysis including number of chronic complications and HbA1c, the number of chronic complications remained an independent factor increasing risk (adjusted OR=1.92, 95% CI 1.21–3.05; p=0.005), while HbA1c was not statistically significant. The prevalence of composite psychosocial distress tended to increase depending on complications. Among participants without chronic complications, it was 8.9%; among those with one complication, 19.2%; and among those with two or more complications, 37.9%. The prevalence of moderate to severe depression, anxiety, and high levels of diabetes-related distress also increased similarly with the number of chronic complications. Conclusion Composite psychosocial distress is present in 1 out of every 6 adults with diabetes. The presence of chronic complications increases the risk of composite psychosocial distress by 3.5 times.

Background: Metabolic dysfunction–associated steatotic liver disease (MASLD) is a major cause of chronic liver disease and is increasingly linked to cardiovascular disease (CVD), the leading cause of mortality globally. Aim: To evaluate individuals participating in early screening using the Hepatic Steatosis Index (HSI) and examine its association with CVD risk levels. Materials and Methods: This population-based retrospective cross-sectional study included 47,542 adults aged 40–70 years who participated in a national screening program between 2023 and 2025. Hepatic steatosis was assessed using the Hepatic Steatosis Index (HSI) and categorized as <30 (no steatosis), 30–36 (indeterminate), and >36 (steatosis). Ten-year CVD risk was estimated using laboratory-based WHO cardiovascular disease risk charts for Central Asia. Associations were evaluated using logistic regression and expressed as odds ratios (ORs) with 95% confidence intervals (CIs). Result: The mean age of participants was 53.18±8.17 years, and 67.1% (31,886) were women. The prevalence of HSI <30, 30–36, and >36 was 8.9% (4,219), 32.1% (15,271), and 59.0% (28,052), respectively. The distribution of low-, moderate-, and high-risk CVD groups was 48.6% (23,115), 41.3% (19,637), and 10.1% (4,790), respectively. The proportion of individuals with high CVD risk was 5.5% in the HSI <30 group and 10.1% in the HSI >36 group. Compared with the reference group, the odds of high CVD risk were increased in the HSI 30–36 group (OR=1.333; 95% CI: 1.152–1.542) and the HSI >36 group (OR=2.401; 95% CI: 2.094–2.753). These associations remained statistically significant after adjustment for age, sex, systolic blood pressure, waist circumference, physical inactivity, and smoking. Conclusion The prevalence of hepatic steatosis in the study population was 59.0%. Individuals with hepatic steatosis had a 1.2-fold higher risk of cardiovascular disease compared with those without steatosis.

Background: Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder associated with cognitive impairment and structural brain alterations. White matter hyperintensities (WMH) detected on magnetic resonance imaging (MRI) serve as critical neuroimaging markers of cerebral small vessel disease. However, research evaluating the WMH burden in the Mongolian population with T2DM using AI-based automated quantitative methods and comparing these findings with a control group remains limited. This research gap provides the rationale and necessity for the current study. Aim: To evaluate and compare the burden of brain white matter hyperintensities (WMH) in adults with type 2 diabetes mellitus (T2DM) versus a control group. Material and Methods: This analytical cross-sectional, retrospective comparative study included participants aged 40 and older who underwent brain MRI at the Mongolia-Japan Hospital of MNUMS between 2019 and 2025. The T2DM group consisted of patients with a confirmed diagnosis, while the control group included individuals without diabetes or prediabetes. After excluding cases with major structural abnormalities, poor image quality, failed automated processing, or incomplete clinical data, 257 out of an initial 283 participants were included in the final analysis (T2DM: 71, Control: 186). 3D T1-weighted MPRAGE and T2-FLAIR MRI sequences were processed using Neurophet AQUA software (version 3.1) to assess total, deep, and periventricular Fazekas scores. Age- and sex-adjusted ordinal logistic regression analysis was performed using SPSS 25.0, with p<0.05 considered statistically significant. Results: A total of 257 participants (T2DM=71, Control=186) were analyzed. There were significant differences between groups in sex distribution (p=0.046) and age categories (p<0.001). The T2DM group exhibited significantly higher total and deep Fazekas scores compared to the control group (total Fazekas: aOR 10.81, 95% CI 5.20-22.49; deep Fazekas: aOR 8.21, 95% CI 4.32-15.60; both p<0.001). Increasing age was associated with higher total (aOR 1.07, 95% CI 1.03-1.11, p=0.001) and deep (aOR 1.04, 95% CI 1.00-1.08, p=0.037) Fazekas scores. Additionally, female sex was associated with higher total (aOR 1.95, 95% CI 1.04–3.63, p=0.036) and deep (aOR 1.95, 95% CI 1.08–3.51, p=0.026) Fazekas score categories. Conclusion Assessment of WMH burden using AI-based automated quantitative MRI processing revealed that T2DM is significantly associated with higher total and deep Fazekas scores. This association remained significant after adjusting for age and sex. These findings suggest that AI-based MRI processing is a suitable method for the objective, quantitative, and standardized assessment of brain WMH burden associated with T2DM.

Background: Thrombotic alterations play a central role in the pathogenesis of both macrovascular and microvascular complications of diabetes mellitus. D-dimer, a fibrin degradation product generated during fibrinolysis, has emerged as a potential biomarker for predicting chronic diabetic complications and assessing their severity. Aim: To determine D-dimer levels in individuals with type 2 diabetes mellitus (T2DM) and investigate their association with various microvascular complications. Materials and Methods: This cross-sectional study included 215 participants with T2DM. Individuals diagnosed with other forms of diabetes, those receiving anticoagulant therapy, and those with liver disease were excluded according to the predefined exclusion criteria. Participants were categorized into two groups according to their D-dimer levels: ≤0.260 μg/mL and >0.260 μg/mL. The prevalence of diabetic retinopathy, nephropathy, and neuropathy was compared between the groups. Multivariable logistic and linear regression models were adjusted for age, sex, and body mass index (BMI). Results: A total of 215 individuals with T2DM were included in the study. The median D-dimer level was 0.260 μg/mL (interquartile range [IQR]: 0.190–0.460). The prevalence of at least one microvascular complication was significantly higher among participants with D-dimer levels above the median than among those with levels at or below the median (51.4% vs. 37.0%, p=0.034). The prevalence of diabetic nephropathy was 33.6% versus 13.0% (p<0.001), while that of diabetic neuropathy was 20.6% versus 10.2% (p=0.035), respectively, indicating a higher burden of chronic complications in the group with elevated D-dimer levels. Participants with D-dimer levels above the median had 2.23 times higher odds of having at least one diabetic microvascular complication (OR=2.23; 95% CI: 1.19–4.18; p=0.013). Conclusions 1. Elevated D-dimer levels were observed in 21.4% of individuals with type 2 diabetes mellitus included in the study. 2. D-dimer levels above the median (0.260 μg/mL) were associated with a twofold increase in the odds of having diabetic microvascular complications (OR=2.23; 95% CI: 1.19–4.18; p=0.013).

Background: The Global Cortical Atrophy (GCA) scale is widely used for visual assessment of cortical atrophy on MRI but is subject to interobserver variability. Automated brain volumetry provides objective measurements; however, its association with visual atrophy grading remains understudied in Mongolia. Aim: To assess the association and agreement between radiology report–based atrophy grades and AI-derived whole-brain volume, and to compare brain volumes in adults with and without type 2 diabetes mellitus (T2DM). Materials and Methods: This retrospective, single-center study included 367 adults aged ≥40 years (T2DM, n=144; controls, n=223). Intracranial volume–adjusted whole-brain volumes were obtained from 3D T1-weighted MRI using Neurophet AQUA v3.1. Atrophy severity recorded in routine radiology reports was coded from 0 to 3. Welch’s ANOVA assessed differences across grades, and ROC analysis evaluated discrimination between adjacent grades. Classification agreement was assessed using stratified five-fold cross-validation and Cohen’s κ. Age- and sex-adjusted ANCOVA compared brain volumes between groups. Results: Mean whole-brain volume decreased across atrophy grades 0–3 (1122.12, 1068.50, 1034.76, and 968.33 mL; Welch’s F(3, 60.04)=207.30; P<0.001). ROC AUCs for adjacent grades were 0.892, 0.897, and 1.000, with corresponding thresholds of 1099.86, 1056.17, and 995.57 mL. Five-fold cross-validation yielded 78.7% exact agreement (289/367), unweighted κ=0.684, and quadratic-weighted κ=0.856. Adjusted whole-brain volume was 11.98 mL lower in T2DM than in controls (95% CI, −22.67 to −1.30; P=0.028), whereas the overall association between T2DM and atrophy grade was not statistically significant (P=0.059). Conclusion Higher report-based atrophy grades were associated with lower whole-brain volumes, with strong quadratic-weighted agreement between volumetric and report-based classifications. Adults with T2DM had lower adjusted brain volumes than controls. Automated volumetry may complement radiologists’ assessments by providing objective quantitative information.

Background: Evaluating diabetes screening coverage, newly diagnosed cases, and regular follow-up indicators is essential for improving diabetes care. However, comparative studies assessing these indicators at the district level in Mongolia remain limited. Aim: To evaluate diabetes screening coverage, the detection of newly diagnosed diabetes, and the distribution of specialist consultations in Chingeltei District, Mongolia, and to assess the current status of diabetes care. Materials and Methods: A retrospective descriptive study was conducted using aggregated healthcare statistics from Chingeltei District for 2024, 2025, and the first half of 2026. Data were collected on diabetes screening coverage, newly diagnosed cases per 1,000 individuals screened, the distribution of specialist consultations, and International Classification of Diseases, 10th Revision (ICD-10) diagnostic codes from 2,448 diabetes-related consultations recorded in 2025. Results: Diabetes screening coverage increased from 68.6% (39,677/57,856) in 2024 to 72.7% (41,953/57,690) in 2025. Coverage was 43.1% during the first half of 2026. The number of newly diagnosed diabetes cases increased from 32 in 2024 to 95 in 2025, corresponding to an increase in the detection rate from 0.81 to 2.26 cases per 1,000 individuals screened (risk ratio [RR]=2.81; 95% confidence interval [CI]: 1.88–4.19). The total numbers of diabetes-related specialist consultations were 9,000 in 2024, 9,127 in 2025, and 7,633 during the first half of 2026. The proportions of consultations classified as active follow-up visits were 35.3%, 54.1%, and 47.9%, respectively. Among 2,448 consultations recorded in 2025, 74.0% were coded as diabetes without complications, whereas 26.0% were coded as diabetes with complications or unspecified complications. Conclusions 1. Although diabetes screening coverage and the number of newly diagnosed cases increased in Chingeltei District from 2024 to 2025, the detection rate per 1,000 people remained low, and diagnostic confirmation was relatively limited. 2. There is a need to improve the accuracy of diagnostic confirmation in the diabetes registry, particularly the coding of diabetic complications.

Background: Polycystic ovary syndrome (PCOS) is characterized by menstrual irregularities, hormonal imbalance, clinical or biochemical hyperandrogenism, and the presence of multiple ovarian follicles. It is one of the major causes of infertility, endometrial carcinoma, and pregnancy-related complications. PCOS is not limited to the reproductive system; it is a chronic disorder associated with metabolic abnormalities and increased cardiovascular risk, which can negatively affect women’s long-term quality of life.In recent years, growing attention has been given to the metabolic alterations seen in women with PCOS-particularly hyperuricemia-and to the emerging role of novel anthropometric indicators such as neck circumference. Given the limited data on these parameters among Mongolian women with PCOS, this study aimed to investigate the relationship between serum uric acid levels and selected anthropometric measurements. Aim: To examine the association between serum uric acid concentration and selected anthropometric parameters in women with polycystic ovary syndrome. Materials and Methods: This analytical cross-sectional study was conducted in a clinical setting and included 120 women aged 15–35 years. Participants completed a structured questionnaire that collected information on age, menstrual cycle characteristics, and medication use. Anthropometric measurements-including height, weight, neck, waist, and hip circumference—were recorded. PCOS was diagnosed based on the Rotterdam criteria. Serum uric acid levels were determined through biochemical testing. Statistical analyses were performed using the t-test and Pearson correlation test. Results: Of the 120 women enrolled, 45.8% (n=55) were diagnosed with PCOS according to the Rotterdam criteria, while 54.2% (n=65) were classified as controls. The mean neck circumference was 36.2±2.5 cm in the PCOS group and 31.5±1.8 cm in the control group (p<0.001). The mean waist circumference was 88.4±7.9 cm in the PCOS group and 75.8±6.7 cm in the control group (p<0.001). The mean hip circumference was 103.5±6.5 cm among women with PCOS and 94.7±5.5 cm in the control group (p<0.01). The waist-to-hip ratio was significantly higher in the PCOS group (0.85±0.07) compared to controls (0.80±0.05, p<0.05). Among women with PCOS, the mean serum uric acid concentration was 476±8.5 µmol/L, which-although not exceeding the upper reference limit for women (400 µmol/L) was slightly higher than the average value in healthy individuals. Conclusion Compared with healthy controls, women with PCOS demonstrated significantly higher anthropometric indices. Although serum uric acid did not surpass the reference maximum, elevated mean levels indicate a potential risk marker for metabolic disorders. The strongest correlation was observed between uric acid and neck circumference, suggesting this parameter may serve as a more sensitive anthropometric indicator than BMI or waist-to-hip rat