Metabolic obesity phenotypes and risk of breast cancer in postmenopausal women

Geoffrey C. Kabat, Mimi Y. Kim, Jennifer S. Lee, Gloria Y. Ho, Scott B Going, Jennifer Beebe-Dimmer, Jo Ann E. Manson, Rowan T. Chlebowski, Thomas E. Rohan

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background: Obesity and the metabolic syndrome (MetS) have both been linked to increased risk of postmenopausal breast cancer; however, their relative contributions are poorly understood. Methods: We examined the association of metabolic phenotypes of obesity defined by presence of the MetS (yes and no) and body mass index (BMI; normal, overweight, obese) with risk of postmenopausal breast cancer in a prospective analysis of a cohort of postmenopausal women (n ∼ 21,000) with baseline measurements of blood glucose, triglycerides, HDL-cholesterol, blood pressure, waist circumference, and BMI. Women were classified into 6 metabolic obesity phenotypes according to their BMI (18.5–<25.0, 25.0–<30.0, ≥30.0 kg/m2) and presence of the MetS (≥3 of the following: waist circumference ≥88 cm, triglycerides ≥150 mg/dL, HDL-C <50 mg/dL, glucose ≥100 mg/dL, and systolic/diastolic blood pressure ≥130/85 mmHg or treatment for hypertension). HRs for incident breast cancer and 95% confidence intervals (95% CI) were estimated using Cox proportional hazards models. Results: Over 15 years of follow-up, 1,176 cases of invasive breast cancer were diagnosed. Obesity, regardless of metabolic health, was associated with increased risk of breast cancer. Being obese and metabolically unhealthy was associated with the highest risk: HR, 1.62; 95% CI, 1.33–1.96. These associations were stronger in women who had never used hormone therapy. Conclusions: Our findings suggest that both obesity and metabolic dysregulation are associated with breast cancer risk. Impact: Beyond BMI, metabolic health should be considered a clinically relevant and modifiable risk factor for breast cancer.

Original languageEnglish (US)
Pages (from-to)1730-1735
Number of pages6
JournalCancer Epidemiology Biomarkers and Prevention
Volume26
Issue number12
DOIs
StatePublished - Dec 1 2017

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Obesity
Breast Neoplasms
Phenotype
Waist Circumference
Blood Pressure
Triglycerides
Confidence Intervals
Health
Proportional Hazards Models
HDL Cholesterol
Blood Glucose
Body Mass Index
Cohort Studies
Hormones
Hypertension
Glucose
Therapeutics

ASJC Scopus subject areas

  • Epidemiology
  • Oncology

Cite this

Metabolic obesity phenotypes and risk of breast cancer in postmenopausal women. / Kabat, Geoffrey C.; Kim, Mimi Y.; Lee, Jennifer S.; Ho, Gloria Y.; Going, Scott B; Beebe-Dimmer, Jennifer; Manson, Jo Ann E.; Chlebowski, Rowan T.; Rohan, Thomas E.

In: Cancer Epidemiology Biomarkers and Prevention, Vol. 26, No. 12, 01.12.2017, p. 1730-1735.

Research output: Contribution to journalArticle

Kabat, GC, Kim, MY, Lee, JS, Ho, GY, Going, SB, Beebe-Dimmer, J, Manson, JAE, Chlebowski, RT & Rohan, TE 2017, 'Metabolic obesity phenotypes and risk of breast cancer in postmenopausal women', Cancer Epidemiology Biomarkers and Prevention, vol. 26, no. 12, pp. 1730-1735. https://doi.org/10.1158/1055-9965.EPI-17-0495
Kabat, Geoffrey C. ; Kim, Mimi Y. ; Lee, Jennifer S. ; Ho, Gloria Y. ; Going, Scott B ; Beebe-Dimmer, Jennifer ; Manson, Jo Ann E. ; Chlebowski, Rowan T. ; Rohan, Thomas E. / Metabolic obesity phenotypes and risk of breast cancer in postmenopausal women. In: Cancer Epidemiology Biomarkers and Prevention. 2017 ; Vol. 26, No. 12. pp. 1730-1735.
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abstract = "Background: Obesity and the metabolic syndrome (MetS) have both been linked to increased risk of postmenopausal breast cancer; however, their relative contributions are poorly understood. Methods: We examined the association of metabolic phenotypes of obesity defined by presence of the MetS (yes and no) and body mass index (BMI; normal, overweight, obese) with risk of postmenopausal breast cancer in a prospective analysis of a cohort of postmenopausal women (n ∼ 21,000) with baseline measurements of blood glucose, triglycerides, HDL-cholesterol, blood pressure, waist circumference, and BMI. Women were classified into 6 metabolic obesity phenotypes according to their BMI (18.5–<25.0, 25.0–<30.0, ≥30.0 kg/m2) and presence of the MetS (≥3 of the following: waist circumference ≥88 cm, triglycerides ≥150 mg/dL, HDL-C <50 mg/dL, glucose ≥100 mg/dL, and systolic/diastolic blood pressure ≥130/85 mmHg or treatment for hypertension). HRs for incident breast cancer and 95{\%} confidence intervals (95{\%} CI) were estimated using Cox proportional hazards models. Results: Over 15 years of follow-up, 1,176 cases of invasive breast cancer were diagnosed. Obesity, regardless of metabolic health, was associated with increased risk of breast cancer. Being obese and metabolically unhealthy was associated with the highest risk: HR, 1.62; 95{\%} CI, 1.33–1.96. These associations were stronger in women who had never used hormone therapy. Conclusions: Our findings suggest that both obesity and metabolic dysregulation are associated with breast cancer risk. Impact: Beyond BMI, metabolic health should be considered a clinically relevant and modifiable risk factor for breast cancer.",
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AU - Kim, Mimi Y.

AU - Lee, Jennifer S.

AU - Ho, Gloria Y.

AU - Going, Scott B

AU - Beebe-Dimmer, Jennifer

AU - Manson, Jo Ann E.

AU - Chlebowski, Rowan T.

AU - Rohan, Thomas E.

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AB - Background: Obesity and the metabolic syndrome (MetS) have both been linked to increased risk of postmenopausal breast cancer; however, their relative contributions are poorly understood. Methods: We examined the association of metabolic phenotypes of obesity defined by presence of the MetS (yes and no) and body mass index (BMI; normal, overweight, obese) with risk of postmenopausal breast cancer in a prospective analysis of a cohort of postmenopausal women (n ∼ 21,000) with baseline measurements of blood glucose, triglycerides, HDL-cholesterol, blood pressure, waist circumference, and BMI. Women were classified into 6 metabolic obesity phenotypes according to their BMI (18.5–<25.0, 25.0–<30.0, ≥30.0 kg/m2) and presence of the MetS (≥3 of the following: waist circumference ≥88 cm, triglycerides ≥150 mg/dL, HDL-C <50 mg/dL, glucose ≥100 mg/dL, and systolic/diastolic blood pressure ≥130/85 mmHg or treatment for hypertension). HRs for incident breast cancer and 95% confidence intervals (95% CI) were estimated using Cox proportional hazards models. Results: Over 15 years of follow-up, 1,176 cases of invasive breast cancer were diagnosed. Obesity, regardless of metabolic health, was associated with increased risk of breast cancer. Being obese and metabolically unhealthy was associated with the highest risk: HR, 1.62; 95% CI, 1.33–1.96. These associations were stronger in women who had never used hormone therapy. Conclusions: Our findings suggest that both obesity and metabolic dysregulation are associated with breast cancer risk. Impact: Beyond BMI, metabolic health should be considered a clinically relevant and modifiable risk factor for breast cancer.

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