Three biomarkers (IL-6, IFN-γ, CXCL10) demonstrated superior diagnostic performance (AUC = 0.9841, sensitivity=88.89%, specificity=92.86%) when combined.<h4>Conclusion</h4>Our findings identify distinct immunological alterations in TB-DM and propose a novel cytokine-based diagnostic panel for this high-risk population. Here, IL6 is linked to tuberculosis.