{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T21:05:31Z","timestamp":1789592731391,"version":"build-2803163510"},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2025,7,17]],"date-time":"2025-07-17T00:00:00Z","timestamp":1752710400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,12,19]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>The effects of semaglutide on non-overweight patients with type 2 diabetes (T2D) remain unclear. We retrospectively compared all-cause mortality, cardiovascular outcomes, and adverse events in patients with T2D with a body mass index (BMI) &amp;lt; 25\u2005kg\/m\u00b2 who received semaglutide or dipeptidyl peptidase 4 (DPP-4) inhibitors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>Based on the TriNetX database of electronic medical records between 2018 and 2020, we identified 340 721 patients with T2D with a BMI &amp;lt;25\u2005kg\/m\u00b2. Of the 6789 patients who received semaglutide, 2454 who received DPP-4 inhibitors after diagnosis were excluded. Of the 41 141 patients who received DPP-4 inhibitors, 5252 patients who received GLP-1 receptor agonists after diagnosis were excluded. After propensity score matching, 4194 patients were included in each group. The primary outcome was the 3-year cumulative incidence of all-cause mortality; the secondary outcomes were acute myocardial infarction (AMI) and stroke. The adverse events included nausea, vomiting, diarrhoea, and hypoglycaemia. The semaglutide group had a significantly lower risk of all-cause mortality compared to the DPP-4 inhibitor group [6.1% vs. 10.7%, P &amp;lt; 0.001; hazard ratio (HR) 0.54, 95% confidence interval (CI) 0.45\u20130.65]. Semaglutide was not associated with the incidence of AMI (6.1% vs. 7.1%, P = 0.173; HR 0.87, 95% CI 0.72\u20131.06) or stroke (8.4% vs. 7.7%, P = 0.220; HR 1.11, 95% CI 0.94\u20131.32). Adverse events, including nausea and vomiting, diarrhoea, and hypoglycaemia, were not significantly different between the groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In patients with T2D and BMI &amp;lt;25\u2005kg\/m2, semaglutide was associated with a lower 3-year risk of all-cause mortality than DPP-4 inhibitors.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjqcco\/qcaf065","type":"journal-article","created":{"date-parts":[[2025,7,17]],"date-time":"2025-07-17T10:11:27Z","timestamp":1752747087000},"page":"1319-1328","source":"Crossref","is-referenced-by-count":8,"title":["Cardiovascular outcomes and safety of semaglutide in non-overweight populations with type 2 diabetes: a comparison with dipeptidyl peptidase 4 inhibitors"],"prefix":"10.1093","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-9639-5470","authenticated-orcid":false,"given":"Takefumi","family":"Kishimori","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine, Omi Medical Center , 1660 Yabase-cho, Kusatsu, Shiga 525-8585 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8213-7999","authenticated-orcid":false,"given":"Takao","family":"Kato","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine , 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsuyuki","family":"Wada","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Omi Medical Center , 1660 Yabase-cho, Kusatsu, Shiga 525-8585 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akira","family":"Tani","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Omi Medical Center , 1660 Yabase-cho, Kusatsu, Shiga 525-8585 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryosuke","family":"Yamaji","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Omi Medical Center , 1660 Yabase-cho, Kusatsu, Shiga 525-8585 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jumpei","family":"Koike","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Omi Medical Center , 1660 Yabase-cho, Kusatsu, Shiga 525-8585 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshihiro","family":"Iwasaki","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Omi Medical Center , 1660 Yabase-cho, Kusatsu, Shiga 525-8585 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takehiro","family":"Matsumoto","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Omi Medical Center , 1660 Yabase-cho, Kusatsu, Shiga 525-8585 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takafumi","family":"Yagi","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Omi Medical Center , 1660 Yabase-cho, Kusatsu, Shiga 525-8585 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaharu","family":"Okada","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Omi Medical Center , 1660 Yabase-cho, Kusatsu, Shiga 525-8585 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