February 13, 2025
Article

Metabolic Markers and Obesity-Related Cancer Risks in Postmenopausal Women

A new look into how metabolic health influences cancer risk among postmenopausal women reveals that metabolic dysfunction, identifiable through specific biomarkers, may increase susceptibility to obesity-related cancers regardless of body mass index (BMI). The study examined over 20,000 women, categorizing their metabolic health using factors like blood pressure, cholesterol levels, and insulin resistance to evaluate their risk. Those with poor metabolic profiles experienced a higher incidence of cancer, emphasizing the importance of metabolic health over BMI alone.

Metabolic dysfunction was assessed through various criteria including fasting glucose and inflammatory markers, highlighting that even women with normal weight could be at increased risk if their metabolic health was compromised. This nuanced understanding suggests that metabolic health screenings could be more predictive of cancer risk than weight alone, providing a compelling case for more personalized health assessments in cancer prevention strategies.

The research findings encourage a shift in focus from weight management to comprehensive metabolic health as a means to prevent cancer, underscoring the need for broader health interventions. This approach could significantly impact public health policies, aiming for earlier detection and targeted prevention measures to combat the rising rates of obesity-related cancers.

Article Information

Metabolic Phenotype and Risk of Obesity-Related Cancers in the Women's Health Initiative

Published In Cancer Prevention Research (Phila). By Prasoona Karra et al.

Abstract

Body mass index (BMI) may misclassify obesity-related cancer (ORC) risk, as metabolic dysfunction can occur across BMI levels. We hypothesized that metabolic dysfunction at any BMI increases ORC risk compared with normal BMI without metabolic dysfunction. Postmenopausal women (n = 20,593) in the Women's Health Initiative with baseline metabolic dysfunction biomarkers [blood pressure, fasting triglycerides, high-density lipoprotein cholesterol, fasting glucose, homeostatic model assessment for insulin resistance (HOMA-IR), and high-sensitive C-reactive protein (hs-CRP)] were included. Metabolic phenotype (metabolically healthy normal weight, metabolically unhealthy normal weight, metabolically healthy overweight/obese, and metabolically unhealthy overweight/obese) was classified using four definitions of metabolic dysfunction: (i) Wildman criteria, (ii) National Cholesterol Education Program Adult Treatment Panel III, (iii) HOMA-IR, and (iv) hs-CRP. Multivariable Cox proportional hazards regression, with death as a competing risk, was used to assess the association between metabolic phenotype and ORC risk. After a median (IQR) follow-up duration of 21 (IQR, 15-22) years, 2,367 women developed an ORC. The risk of any ORC was elevated among metabolically unhealthy normal weight (HR = 1.12, 95% CI, 0.90-1.39), metabolically healthy overweight/obese (HR = 1.15, 95% CI, 1.00-1.32), and metabolically unhealthy overweight/obese (HR = 1.35, 95% CI, 1.18-1.54) individuals compared with metabolically healthy normal weight individuals using Wildman criteria. The results were similar using Adult Treatment Panel III criteria, hs-CRP alone, or HOMA-IR alone to define metabolic phenotype. Individuals with overweight or obesity with or without metabolic dysfunction were at higher risk of ORCs compared with metabolically healthy normal weight individuals. The magnitude of risk was greater among those with metabolic dysfunction, although the CIs of each category overlapped. Prevention Relevance: Recognizing metabolic dysfunction as a significant risk factor for ORCs underscores the importance of preventive measures targeting metabolic health improvement across all BMI categories.