Association of frailty with the incidence risk of cardiovascular disease and type 2 diabetes mellitus in long-term cancer survivors: a prospective cohort study.
Association of frailty with the incidence risk of cardiovascular disease and type 2 diabetes mellitus in long-term cancer survivors: a prospective cohort study.
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长期癌症幸存者的虚弱与心血管疾病和2型糖尿病发病风险的关系：一项前瞻性队列研究。
DOI：
10.1186/s12916-023-02774-1
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发表时间：
2023-02-24
期刊：
影响因子：
9.3
通讯作者：
Liu, Zuyun
中科院分区：
文献类型：
--
作者：
Cao, Xingqi;Yang, Zhenqing;Li, Xueqin;Chen, Chen;Hoogendijk, Emiel O.;Zhang, Jingyun;Yao, Nengliang Aaron;Ma, Lina;Zhang, Yawei;Zhu, Yong;Zhang, Xuehong;Du, Yuxian;Wang, Xiaofeng;Wu, Xifeng;Gill, Thomas M.;Liu, Zuyun
癌症幸存者的合并症仍然是一个严重的医疗负担，需要适当的管理。本研究使用两种广泛使用的虚弱指标，旨在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（T2 DM）的发病风险相关。我们纳入了13，388名无CVD的长期癌症幸存者（入组前诊断为癌症超过5年）和6101名无T2 DM的长期癌症幸存者，招募时（年龄40-69岁）来自英国生物样本库。通过基线时的虚弱表型（FP_Frailty，范围：0-5）和虚弱指数（FI_Frailty，范围：0-1）评估虚弱。CVD和T2 DM事件分别通过关联的医院数据和初级保健数据确定。使用考克斯比例风险回归模型检查相关性。与非虚弱参与者相比，（FP_Frailty [满足1-2个组件]：风险比[HR]=1.18，95%置信区间[CI]：1.05，1.32; FI_Frailty [0.10< FI ≤0.21]：HR=1.51，95% CI：1.32，1.74）和虚弱在多变量校正模型中，（FP_Frailty [满足≥3个组分]：HR=2.12，95% CI：1.73，2.60; FI_Frailty [FI >0.21]：HR=2.19，95% CI：1.85，2.59）的CVD风险显著更高。观察到FI_Frailty与T2 DM事件风险的相似相关性。我们没有找到FP_Frailty的这种关联。值得注意的是，极早期虚弱（FP_Frailty为1，FI_Frailty为0.1-0.2）也与CVD和T2 DM风险呈正相关（仅FI_Frailty）。一系列敏感性分析证实了研究结果的稳健性。虚弱，即使是在非常早期的阶段，与长期癌症幸存者中CVD和T2 DM的发病风险呈正相关，尽管虚弱指标之间存在差异。虽然这些发现需要验证，但它们表明，对癌症幸存者的虚弱进行常规监测、预防和干预计划可能有助于预防晚期合并症，并最终提高他们的生活质量。特别是，当医疗资源有限时，建议针对那些处于虚弱早期阶段的人进行干预。在线版本包含补充材料，可通过10.1186/s12916-023-02774-1获得。
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. The online version contains supplementary material available at 10.1186/s12916-023-02774-1.
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影响因子：
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DOI：
10.1016/s2666-7568(20)30014-3
发表时间：
2020-12
期刊：
The lancet. Healthy longevity
影响因子：
--
作者：
Hanlon P;Fauré I;Corcoran N;Butterly E;Lewsey J;McAllister D;Mair FS
通讯作者：
Mair FS