{
  "abstract": "Diabetes is associated with an increased risk of tuberculosis (TB), but whether the class of glucose-lowering therapy is associated with TB outcomes remains uncertain. We conducted a retrospective observational cohort study to examine the association between glucagon-like peptide-1 receptor agonist (GLP-1 RA) use versus dipeptidyl peptidase-4 inhibitor (DPP-4i) use and the risk of TB and mortality. We used de-identified records from the TriNetX Global Collaborative Network. Adults with diabetes who had a qualifying record for either a GLP-1 RA or a DPP-4i between 2016 and 2024 were eligible. Cohort entry was defined as the first qualifying drug-class record during this period. Patients with prior-year use of the comparator drug class, a history of TB, or death before cohort entry were excluded. Propensity score matching was performed at a 1:1 ratio. Outcomes assessed during days 1–365 included TB (ICD-10-CM A15–A19), the platform-defined death outcome, and a composite outcome of gastrointestinal and hepatobiliary diagnoses. After matching, 466,903 patients remained in each group. GLP-1 RA exposure was associated with fewer recorded TB events, deaths, and gastrointestinal/hepatobiliary events than DPP-4i exposure during the first year after cohort entry. TB was recorded in 155 GLP-1 RA users and 320 DPP-4i users (HR, 0.472; 95% CI, 0.390–0.572). The corresponding numbers for the platform-defined death outcome were 7575 and 14,572 (HR, 0.505; 95% CI, 0.492–0.520), and those for gastrointestinal/hepatobiliary diagnoses were 15,914 and 20,559 (HR, 0.750; 95% CI, 0.735–0.766). The analysis restricted to patients with type 2 diabetes (ICD-10-CM E11) yielded a similar association for TB. Residual imbalance in body mass index (BMI) and residual confounding, including confounding by indication, limit a causal interpretation.",
  "abstract_shown": true,
  "affiliations": [
    "Division of Chest Medicine, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung 813414, Taiwan",
    "Doctoral Program of Clinical and Experimental Medicine, College of Medicine, National Sun Yat-sen University, Kaohsiung 804201, Taiwan",
    "Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung 813414, Taiwan",
    "School of Medicine, College of Medicine, National Sun Yat-sen University, Kaohsiung 804201, Taiwan",
    "Cancer Center, Kaohsiung Veterans General Hospital, Kaohsiung 813414, Taiwan"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 8,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Chun-Hsiang Hsu",
      "orcid": "0009-0007-1571-737X"
    },
    {
      "affs": [
        2
      ],
      "name": "Renin Chang",
      "orcid": "0000-0003-1016-2233"
    },
    {
      "affs": [
        0
      ],
      "name": "Chiu-Fan Chen"
    },
    {
      "affs": [
        0,
        3
      ],
      "name": "Kuo-An Chu"
    },
    {
      "affs": [
        0
      ],
      "name": "You-Cheng Jiang"
    },
    {
      "affs": [
        0
      ],
      "name": "Wei-Cheng Hong"
    },
    {
      "affs": [
        0
      ],
      "name": "I-Yuan Chen"
    },
    {
      "affs": [
        0,
        4
      ],
      "name": "Min-Hsi Lin"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/67de7r1zcdfr8.bib",
  "cited_by": 0,
  "doi": "10.3390/ijms27209137",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13705376/?tool=EBI",
  "id": "67de7r1zcdfr8",
  "issns": [
    "1422-0067"
  ],
  "landing_url": "https://www.mdpi.com/1422-0067/27/20/9137",
  "language": "eng",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2712|Diabetes Treatment and Management"
    ]
  ],
  "openalex": "W7222330114",
  "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13705376/pdf/?tool=EBI",
  "pmcid": "PMC13705376",
  "pmid": null,
  "published": "2026-10-01",
  "publisher": "MDPI AG",
  "ris": "https://research.draconitic.com/paper/67de7r1zcdfr8.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:18:55Z",
      "native_id": "10.3390/ijms27209137",
      "source": "crossref",
      "url": "https://www.mdpi.com/1422-0067/27/20/9137"
    },
    {
      "first_seen": "2026-10-30T12:21:44Z",
      "native_id": "PMC:PMC13705376",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13705376"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2712|Diabetes Treatment and Management",
      "subfield": "endocrinology-metabolism"
    }
  ],
  "title": "Association of Glucagon-like Peptide-1 Receptor Agonists Versus Dipeptidyl Peptidase-4 Inhibitors with Tuberculosis and Mortality in Adults with Diabetes",
  "title_text": "Association of Glucagon-like Peptide-1 Receptor Agonists Versus Dipeptidyl Peptidase-4 Inhibitors with Tuberculosis and Mortality in Adults with Diabetes",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:21:44Z",
  "url": "https://research.draconitic.com/paper/67de7r1zcdfr8",
  "venue": "International Journal of Molecular Sciences",
  "versions": []
}