癌症幸存者的合併症仍然是令人担忧的医疗负担，需要适当的管理。本研究旨在使用两种广泛使用的虚弱指标，评估虚弱是否与长期癌症幸存者的心血管疾病（CVD）和2型糖尿病（T2DM）发生风险相关。我们在英国生物银行中招募了13,388名诊断癌症超过5年且没有CVD和6101名没有T2DM（年龄在40-69岁之间）的长期癌症幸存者。基线时使用虚弱表型指标（FP_Frailty，范围：0-5）和虚弱指数（FI_Frailty，范围：0-1）进行虚弱评估。通过链接的医院数据和初级保健数据分别确认了心血管疾病和2型糖尿病的发病率。使用Cox比例风险回归模型考虑相关性。与非虚弱参与者相比，患有健康虚弱症（FP_Frailty [满足1-2个组成部分] ：风险比[HR] = 1.18，95％置信区间[CI]：1.05，1.32; FI_Frailty [0.10 0.21] ：HR = 2.19，95％CI：1.85，2.59）在多元调整模型中具有显着更高的CVD风险。观察到FI_Frailty与发生T2DM的风险的类似关联，但未发现FP_Frailty的这种关联。值得注意的是，虚弱的非常早期阶段（FP_Frailty为1，FI_Frailty为0.1-0.2）也与CVD和T2DM（仅限于FI_Frailty）的风险呈正相关。一系列敏感性分析确认了结果的健壮性。虚弱，即使在很早的阶段，也与长期癌症幸存者的CVD和T2DM发病风险呈正相关，尽管虚弱指标存在差异。虽然需要验证这些发现，但建议对癌症幸存者进行虚弱的例行监测、预防和干预程序，以预防晚期合并症并最终提高其生活质量。特别是，建议干预针对在虚弱早期阶段的人员，因为此时医疗资源有限。 ©2023.作者。

Comorbidities among cancer survivors remain a serious healthcare burden and require appropriate management. Using two widely used frailty indicators, this study aimed to evaluate whether frailty was associated with the incidence risk of cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM) among long-term cancer survivors.We included 13,388 long-term cancer survivors (diagnosed with cancer over 5 years before enrolment) free of CVD and 6101 long-term cancer survivors free of T2DM, at the time of recruitment (aged 40-69 years), from the UK Biobank. Frailty was assessed by the frailty phenotype (FP_Frailty, range: 0-5) and the frailty index (FI_Frailty, range: 0-1) at baseline. The incident CVD and T2DM were ascertained through linked hospital data and primary care data, respectively. The associations were examined using Cox proportional hazards regression models.Compared with non-frail participants, those with pre-frailty (FP_Frailty [met 1-2 of the components]: hazard ratio [HR]=1.18, 95% confidence interval [CI]: 1.05, 1.32; FI_Frailty [0.10< FI ≤0.21]: HR=1.51, 95% CI: 1.32, 1.74) and frailty (FP_Frailty [met ≥3 of the components]: HR=2.12, 95% CI: 1.73, 2.60; FI_Frailty [FI >0.21]: HR=2.19, 95% CI: 1.85, 2.59) had a significantly higher risk of CVD in the multivariable-adjusted model. A similar association of FI_Frailty with the risk of incident T2DM was observed. We failed to find such an association for FP_Frailty. Notably, the very early stage of frailty (1 for FP_Frailty and 0.1-0.2 for FI_Frailty) was also positively associated with the risk of CVD and T2DM (FI_Frailty only). A series of sensitivity analyses confirmed the robustness of the findings.Frailty, even in the very early stage, was positively associated with the incidence risk of CVD and T2DM among long-term cancer survivors, although discrepancies existed between frailty indicators. While the validation of these findings is required, they suggest that routine monitoring, prevention, and interventive programs of frailty among cancer survivors may help to prevent late comorbidities and, eventually, improve their quality of life. Especially, interventions are recommended to target those at an early stage of frailty when healthcare resources are limited.© 2023. The Author(s).