Our study disclosed that DPP-4 inhibitors were not significantly associated with higher risks of all-cause mortality, major cardiovascular events, and HCC but were significantly associated with higher risks of cirrhotic decompensation [aHR 1.35 (1.03–1.77)] and hepatic failure [aHR 1.35 (1.02–1.79)] than non-users (Table 1) (28). This evidence concerns the gene DPP4 and liver failure.