Table 3.

Hazard ratios and 95% confidence intervals for the combined effects of metabolic abnormalities and central obesity on risk of invasive breast cancer by time-varying menopausal status

	Metabolic phenotype	BMI (kg/m2)	Metabolic abnormalities*	Central obesity†	No. of participants at baseline‡	Person-years	No. of cases	Multivariable-adjusted HR (95% CI)§
Post-menopause	MHNW	< 25	No	No	6,968	48,955	218	1 (reference)
	MUNW	< 25	No	Yes	214	1,304	12	2.12 (1.19–3.80)
			Yes	No	3,344	19,743	117	1.20 (0.95–1.50)
			Yes	Yes	256	1,413	9	1.32 (0.67–2.57)
	MHO	≥ 25	No	No	3,595	24,115	127	1.24 (0.99–1.55)
	MUO	≥ 25	No	Yes	4,034	25,878	174	1.59 (1.30–1.96)**
			Yes	No	3,257	19,165	135	1.46 (1.17–1.82)**
			Yes	Yes	8,864	50,211	339	1.48 (1.24–1.78)**
Pre-menopause	MHNW	< 25	No	No	5,182	21,183	117	1 (reference)
	MUNW	< 25	No	Yes	121	454	1	NA
			Yes	No	505	1,584	9	0.96 (0.48–1.90)
			Yes	Yes	29	93	1	NA
	MHO	≥ 25	No	No	2,419	9,504	53	0.94 (0.67–1.31)
	MUO	≥ 25	No	Yes	2,612	10,150	46	0.78 (0.55–1.12)
			Yes	No	523	1,645	5	0.49 (0.20–1.21)
			Yes	Yes	1,676	5,444	21	0.63 (0.38–1.02)

Abbreviations: MHNW, metabolically healthy normal weight; MUNW, metabolically unhealthy normal weight; MHO, metabolically healthy overweight/obese; MUO, metabolically unhealthy overweight/obese; BMI, body mass index; HR, hazard ratio; 95% CI, 95% confidence interval; ER, estrogen receptor; +, positive.

^*Metabolic abnormalities were here defined by only using elevated blood pressure, type 2 diabetes, and dyslipidemia, and excluding central obesity.

^†Waist circumference ≥ 88 cm.

^‡For this analysis, postmenopausal person-years begin to accrue one year after enrollment and include person-years from both women who were post-menopausal at enrollment and those who were pre-menopausal at baseline but experienced menopause during follow-up.

^§Adjusted for the same covariates used in Table 2.

^**HR was significantly different from pre-menopausal breast cancer.