{
  "abstract": "Background\n\nGlucagon-like peptide-1 receptor agonists (GLP-1 RAs) are widely used to treat type 2 diabetes mellitus, but their associations with thyroid disorders remain uncertain. We evaluated whether initiating a GLP-1 RA, compared with initiating a dipeptidyl peptidase-4 inhibitor (DPP-4i), was associated with newly recorded autoimmune thyroiditis and other thyroid outcomes.Methods\n\nThis new-user, active-comparator cohort study emulated a target trial using the TriNetX Collaborative Network. Adults with type 2 diabetes who initiated a GLP-1 RA or DPP-4i between January 1, 2018, and December 31, 2022, and had no prior use of either drug class were eligible. Patients with pre-existing thyroid disease, any neoplasm, immunosuppressant or immunostimulant use, transplantation, or end-stage kidney disease or dialysis were excluded. Propensity score matching yielded 107,912 patients per group. The primary outcome was newly recorded autoimmune thyroiditis; secondary outcomes were nontoxic uninodular goiter, nontoxic multinodular goiter, and thyroid malignancy. Cox models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs), with false discovery rate adjustment. Follow-up extended from 1 day after treatment initiation to 4 years.Results\n\nAutoimmune thyroiditis occurred in 524 GLP-1 RA users (0.49%) and 417 DPP-4i users (0.39%). GLP-1 RA initiation was associated with a higher risk of autoimmune thyroiditis (HR, 1.26; 95% CI, 1.11-1.43; FDR-adjusted P = 0.002). Modestly higher risks were also observed for nontoxic uninodular goiter (HR, 1.07; 95% CI, 1.01-1.13) and nontoxic multinodular goiter (HR, 1.11; 95% CI, 1.03-1.19). The risk of thyroid malignancy did not differ significantly (HR, 0.93; 95% CI, 0.77-1.12). Findings were generally consistent across sensitivity and subgroup analyses, although heterogeneity was observed across body mass index strata.Conclusion\n\nAmong adults with type 2 diabetes, GLP-1 RA initiation was associated with small increases in newly recorded autoimmune thyroiditis and benign nodular thyroid disease, but not with thyroid malignancy. Given the small absolute differences and the potential for residual confounding and surveillance bias, these findings require validation in future studies.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Nephrology, New Taipei Municipal Tu Cheng Hospital, New Taipei City, Taiwan.",
    "College of Medicine, Chang Gung University, Taoyuan, Taiwan.",
    "Kidney Research Center, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.",
    "Division of Nephrology, Department of Internal Medicine, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.",
    "Department of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan.",
    "Data Analytics Group, Department of Digital Medicine, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.",
    "Division of Endocrinology and Metabolism, Department of Internal Medicine, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.",
    "Department of Nephrology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 7,
  "authors": [
    {
      "affs": [
        0,
        1,
        2
      ],
      "name": "Ching-Chung Hsiao"
    },
    {
      "affs": [
        3,
        4,
        5
      ],
      "name": "Ming-Hsien Tsai"
    },
    {
      "affs": [
        6
      ],
      "name": "Jian-Yu Jhu"
    },
    {
      "affs": [
        5
      ],
      "name": "Ya-Fang Liu"
    },
    {
      "affs": [
        1,
        2,
        7
      ],
      "name": "Chieh-Li Yen"
    },
    {
      "affs": [
        1,
        2,
        7
      ],
      "name": "Jia-Jin Chen"
    },
    {
      "affs": [
        6
      ],
      "name": "Pei-Chi Chen"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/czhyyxy529vhj.bib",
  "cited_by": 0,
  "doi": "10.7150/ijms.141099",
  "fulltext_url": "https://europepmc.org/articles/PMC13685433",
  "id": "czhyyxy529vhj",
  "issns": [
    "1449-1907"
  ],
  "landing_url": "https://europepmc.org/article/MED/42910111",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2712|Diabetes Treatment and Management"
    ]
  ],
  "openalex": "W7222866734",
  "pdf_url": "https://europepmc.org/articles/PMC13685433?pdf=render",
  "pmcid": "PMC13685433",
  "pmid": "42910111",
  "published": "2026-10-02",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/czhyyxy529vhj.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:14Z",
      "native_id": "MED:42910111",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42910111"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2712|Diabetes Treatment and Management",
      "subfield": "endocrinology-metabolism"
    }
  ],
  "title": "Association of GLP-1 Receptor Agonist Use with Thyroid Outcomes in Adults with Type 2 Diabetes.",
  "title_text": "Association of GLP-1 Receptor Agonist Use with Thyroid Outcomes in Adults with Type 2 Diabetes.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:20:14Z",
  "url": "https://research.draconitic.com/paper/czhyyxy529vhj",
  "venue": "International journal of medical sciences",
  "versions": []
}