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<p>Endocrine therapy (ET) is a cornerstone of treatment for hormone receptor-positive (HR+ ) breast cancer but has been linked to metabolic toxicities, including nonalcoholic fatty liver disease (NAFLD). Hispanic individuals are disproportionately affected by metabolic comorbidities, yet data on ET-associated NAFLD risk in this population are limited. We retrospectively analyzed 465 women with early-stage HR+ breast cancer who initiated adjuvant ET between 2010 and 2023 at a single academic center. Eligible patients had baseline and follow-up imaging for NAFLD assessment. Exclusion criteria included pre-existing liver disease, significant alcohol use, ET duration &lt;6 months, or missing ethnicity data. Patients were stratified as Hispanic or non-Hispanic. Time to clinically detected, imaging-confirmed NAFLD was assessed using Kaplan-Meier analysis and Cox proportional hazards modeling. Overall, 64 of 465 patients (13.8%) developed clinically detected, imaging-confirmed NAFLD during follow-up. The cumulative occurrence was significantly higher among Hispanic compared with non-Hispanic patients (20.6% vs. 11.7%, <i>p</i> = 0.02). In multivariable analysis, Hispanic ethnicity (HR: 1.75, 95% CI: 1.01–3.02, <i>p</i> = 0.04), overweight (HR: 2.91, 95% CI: 1.32–6.46, <i>p</i> = 0.008), and obesity (HR: 3.15, 95% CI: 1.42–6.97, <i>p</i> = 0.005) were associated with a higher observed risk of clinically detected, imaging-confirmed NAFLD after adjustment for available metabolic and treatment-related factors. Hispanic ethnicity was associated with a higher observed risk of clinically detected, imaging-confirmed NAFLD in this retrospective cohort, even after adjusting for metabolic risk factors. These findings highlight the need for proactive hepatic monitoring and tailored metabolic interventions to support metabolic health and equitable survivorship care in diverse breast cancer populations.</p>

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Ethnic differences in nonalcoholic fatty liver disease among women with early-stage breast cancer receiving endocrine therapy

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年8月2日

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  • Mengni Guo,
  • Kevin Bera,
  • Darren Wijaya,
  • Andreas Lau,
  • Adam Hagele,
  • Michael Borecky,
  • Riyan Bittar,
  • Man Kit Ho,
  • Ami Patel,
  • Roshni Narurkar,
  • Gayathri Nagaraj

摘要

Endocrine therapy (ET) is a cornerstone of treatment for hormone receptor-positive (HR+ ) breast cancer but has been linked to metabolic toxicities, including nonalcoholic fatty liver disease (NAFLD). Hispanic individuals are disproportionately affected by metabolic comorbidities, yet data on ET-associated NAFLD risk in this population are limited. We retrospectively analyzed 465 women with early-stage HR+ breast cancer who initiated adjuvant ET between 2010 and 2023 at a single academic center. Eligible patients had baseline and follow-up imaging for NAFLD assessment. Exclusion criteria included pre-existing liver disease, significant alcohol use, ET duration <6 months, or missing ethnicity data. Patients were stratified as Hispanic or non-Hispanic. Time to clinically detected, imaging-confirmed NAFLD was assessed using Kaplan-Meier analysis and Cox proportional hazards modeling. Overall, 64 of 465 patients (13.8%) developed clinically detected, imaging-confirmed NAFLD during follow-up. The cumulative occurrence was significantly higher among Hispanic compared with non-Hispanic patients (20.6% vs. 11.7%, p = 0.02). In multivariable analysis, Hispanic ethnicity (HR: 1.75, 95% CI: 1.01–3.02, p = 0.04), overweight (HR: 2.91, 95% CI: 1.32–6.46, p = 0.008), and obesity (HR: 3.15, 95% CI: 1.42–6.97, p = 0.005) were associated with a higher observed risk of clinically detected, imaging-confirmed NAFLD after adjustment for available metabolic and treatment-related factors. Hispanic ethnicity was associated with a higher observed risk of clinically detected, imaging-confirmed NAFLD in this retrospective cohort, even after adjusting for metabolic risk factors. These findings highlight the need for proactive hepatic monitoring and tailored metabolic interventions to support metabolic health and equitable survivorship care in diverse breast cancer populations.