Table 3.
Metabolic obesity phenotypes defined by presence of the MetS and BMI in relation to risk of breast cancer, in the Women’s Health Initiative CVD Biomarkers Sub-Cohort
| Metabolic phenotypes | Cases, N | Noncases, N | HRa (95% CI) |
|---|---|---|---|
| Total population (n cases 1,176; n noncases 19,819) | |||
| MHNW | 219 | 4,366 | 1.00 (Ref.) |
| MUNW | 28 | 647 | 0.86 (0.51–1.38) |
| MHOW | 261 | 4,904 | 1.08 (0.90–1.31) |
| MUOW | 128 | 2,307 | 1.17 (0.93–1.47) |
| MHO | 202 | 3,145 | 1.31 (1.07–1.61) |
| MUO | 345 | 4557 | 1.61 (1.34–1.94) |
| Never used hormone therapy (n cases 714; n noncases 11,855) | |||
| MHNW | 121 | 2,486 | 1.00 (Ref.) |
| MUNW | 12 | 337 | 0.76 (0.40–1.45) |
| MHOW | 148 | 2,800 | 1.14 (0.88–1.46) |
| MUOW | 75 | 1,411 | 1.18 (0.87–1.60) |
| MHO | 125 | 1,855 | 1.45 (1.11–1.90) |
| MUO | 233 | 2,966 | 1.81 (1.42–2.29) |
| Never used hormone therapy and not in treatment arms of the HT clinical trials (n cases 458; n noncases 7,827) | |||
| MHNW | 70 | 1,584 | 1.00 (Ref.) |
| MUNW | 9 | 196 | 1.15 (0.55–2.40) |
| MHOW | 95 | 1,902 | 1.18 (0.85–1.63) |
| MUOW | 48 | 891 | 1.27 (0.86–1.88) |
| MHO | 83 | 1,319 | 1.45 (1.03–2.04) |
| MUO | 153 | 1,935 | 2.01 (1.48–2.73) |
| First 3 years of follow-up excluded (n cases 983; n noncases 19,410) | |||
| MHNW | 176 | 4,281 | 1.00 (Ref.) |
| MUNW | 17 | 517 | 0.90 (0.54–1.51) |
| MHOW | 214 | 4,830 | 1.11 (0.90–1.37) |
| MUOW | 111 | 2,244 | 1.23 (0.96–1.58) |
| MHO | 174 | 3,087 | 1.38 (1.10–1.73) |
| MUO | 291 | 4,451 | 1.65 (1.35–2.02) |
Abbreviations: MHNW, metabolically healthy normal weight; MUNW, metabolically unhealthy normal weight; MHOW, metabolically healthy overweight; MUOW, metabolically unhealthy overweight; MHO, metabolically healthy obese; MUO, metabolically unhealthy obese.
Adjusted for age (continuous), smoking status (never, former, current), pack-years of smoking (continuous), alcohol intake (drinks/week – continuous), physical activity (MET-h/wk), age at first birth (<20, 20–29, ≥30, missing), age at menarche (<12, 12, 13, ≥14), age at menopause (<45, 45–54, ≥55, missing), oral contraceptives (never, ever), hormone therapy (never, ever), parous/nulliparous, family history of breast cancer in first-degree relative (no, yes), history of breast biopsy (no, yes), breastfed for more than 6 months (no, yes), education (less than high school grad, high school grad/some college, college grad, post-college), ethnicity (white, black, other), allocation to the OS or specific arm of clinical trials.