This study aims to explore the patterns and associated factors of thyroid related disease comorbidity to provide a novel insight for comorbidity prevention and management. After multi-stage stratified cluster random sampling, a total of 2272 participants were recruited, and relevant data were collected through door-to-door visits and the standardized questionnaire, anthropometric measurements and biochemical examinations. Logistic regression analysis was utilized to explore potential influences, and least absolute shrinkage and selection operator (LASSO) regression was applied to control for multicollinearity between variables. We found that there were 888 individuals with thyroid disease, yielding prevalence rates ranging from 0.35% to 17.96% for thyroid related disorders. Of these, 555 enrollees had concomitant diseases and the number of comorbidity was dominated by two conditions, with subclinical hypothyroidism and hyperlipidemia being the top ranking. Female sex acted as a protective factor for thyroid disease comorbidity, while advancing age, familial history of diabetes, large waist circumference, and fast heart rate were all substantial risk factors. The risk of comorbidity rose steeply with growing waist circumference. Appropriate measures should be taken to reduce the occurrence of comorbidity and the burden of disease.

The authors have declared no competing interest.

by the Science and Education Department of the National Health and Family Planning Commission. It belongs to the This study was funded by 2014 Special Research Project for the Health Industry. The project funds were allocated by the Ministry of Finance. Party B (the First Affiliated Hospital of Xi'an Jiaotong University School of Medicine) will receive the corresponding research funds.

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

Institutional Affiliation: Medical Research Ethics Committee of the First Affiliated Hospital of China Medical University Department of Endocrinology and Metabolic Diseases Name of the Ethical Supervisory Institution: Medical Research Ethics Committee of the First Affiliated Hospital of China Medical University Ethical Approval Status: This research has been approved by the ethical review committee, and the approval number is AF-S0P-07-1.0-01.

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

Yes

I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

Yes

All data produced in the present study are available upon reasonable request to the authors