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Metabolic dysfunction‐associated steatotic liver disease (MASLD) is the most common pediatric liver disease and can progress to liver fibrosis. Latino adolescents have increased MASLD and fibrosis risk. While fibrosis is diagnosed by biopsy or imaging, more accessible, noninvasive, and economical screening methods are needed. We aimed to use plasma metabolomics/lipidomics to identify potential fibrosis biomarkers in Latino adolescents with obesity. Liver stiffness (LS) was measured in 93 Latino adolescents with obesity using magnetic resonance elastography. Metabolites and lipids were extracted from plasma and identified on Compound Discoverer. Associations between metabolites/lipids and fibrosis (LS > 2.73 kPa) were determined using linear regression models after covariate adjustment. False discovery rate (FDR) adjusted Pearson's correlations were performed. Analytes yielding significant FDR‐adjusted correlations were examined further by receiver operator curve analysis. Mean (±standard deviation) alanine transaminase (ALT) was 45.7(±65.2) IU/L, hepatic fat fraction was 12.7(±9.1)%, and LS was 2.4(±0.3) kPa. We identified 795 metabolites and 413 lipids in plasma, but only one single metabolite, dihydroxyacetone phosphate (DHAP), a marker of triglyceride synthesis, was significantly associated with fibrosis after FDR adjustment (p< 0.05). In terms of predicting fibrosis, ALT had an area under the curve (AUC) of 0.79, and DHAP had an AUC of 0.79. When combined, ALT + DHAP had an AUC of 0.89. The combination of ALT + DHAP may have the potential as an accurate, noninvasive test for liver fibrosis. Our data are limited to Latino children with obesity, and a larger cohort should be examined to further validate this novel biomarker. Metabolic dysfunction‐associated steatotic liver disease (MASLD) is the most common cause of pediatric liver disease and can progress to liver fibrosis in advanced disease.Two well‐known risk factors for adolescent MASLD are Latino ethnicity/race and obesity.Liver biopsies, the gold standard for diagnosis of liver fibrosis, are invasive, expensive, and prone to sampling error. Metabolic dysfunction‐associated steatotic liver disease (MASLD) is the most common cause of pediatric liver disease and can progress to liver fibrosis in advanced disease. Two well‐known risk factors for adolescent MASLD are Latino ethnicity/race and obesity. Liver biopsies, the gold standard for diagnosis of liver fibrosis, are invasive, expensive, and prone to sampling error. The combination of alanine transaminase + dihydroxyacetone phosphate, a marker of triglyceride synthesis, may have the potential as an accurate, noninvasive test for liver fibrosis in Latino adolescents with obesity. The combination of alanine transaminase + dihydroxyacetone phosphate, a marker of triglyceride synthesis, may have the potential as an accurate, noninvasive test for liver fibrosis in Latino adolescents with obesity.

The number of patients requiring chemotherapy is projected to rise to 15 million by 2040.1Although chemotherapy remains a critical component of cancer treatment, its mechanism of action—affecting both cancerous and healthy cells—often leads to significant side effects. These adverse effects can result in a decline in health-related quality of life and functional abilities.2Chemotherapy-related cognitive impairment (CRCI) is a common side effect in both CNS and non-CNS cancers. However, most research has primarily focused on investigating CRCI in CNS cancers, leaving gaps in our understanding of the mechanism leading to CRCI in non-CNS cancers. With survival rates improving,3it is increasingly important to further investigate the pathophysiology of these cognitive changes among non-CNS cancer survivors, particularly to determine whether chemotherapy-induced brain changes are reversible. Understanding these mechanisms is crucial for tailoring cancer treatments and developing interventions to mitigate long-term cognitive impairment and improve quality of life for survivors.