Genetic microRNAs could predict Type 2 diabetes before a positive diagnosis
Elena Flowers, Ph.D., RN, professor of physiological nursing at UC San Francisco's School of Nursing, is not your typical registered nurse. A research scientist with a doctorate from the School of Nursing at UCSF, Flowers focuses on how a person's environment and life experiences interact with their biology to affect their health outcomes, especially with type 2 diabetes.
Type 2 diabetes is a top 10 cause of death in the U.S. and impacts more than 36 million people. The condition, in which the body becomes resistant to insulin or doesn't make enough insulin to process a person's sugar intake, can be caused by a combination of genetics, lifestyle, and the environment. It is usually diagnosed in adulthood.
Flowers asks, "What if a disposition for type 2 diabetes could be recognized early at a molecular level before the body begins a trajectory toward the disease?" The answer, she says, is in the study of microRNA, tiny molecules in the blood that can affect how genes are used by the body.
Why is microRNA important?
RNA, made from DNA, helps to carry out the instructions for making proteins, the building blocks of life. And microRNA, small sections of RNA, carry "instructions" that control which genes in our DNA turn on to receive the instructions.
These microRNA can be influenced by many factors, including stress and inflammation in the body. Understanding microRNA better might help us understand how stress, behaviors, and environments lead to different health outcomes for people with similar genetic risks.
What does the amount of microRNA tell us about a person's health?
A simple blood test to measure the amount of microRNA could identify early signs of type 2 diabetes before signs and symptoms appear. It could also be used to track how well a treatment is working.
How might this influence diabetes treatment?
In some of my recent research, I found that the diabetes drug metformin alters the type and amount of microRNA that we think regulate glucose absorption and inflammation in the body. This could serve as a biomarker, detectable in the blood, that we can use to monitor a patient's responses to treatments or predict if a patient will respond favorably to metformin. This might ultimately guide microRNA-based therapies and lead to personalized medicine treatments for diabetes prevention.
Are there other factors besides stress and the environment that affect microRNA?
Yes, I am especially interested in how social factors like race, ethnicity, and migration affect health. Our current studies focus on differences in microRNA expression based on these factors. The impact of identifying adverse social determinants of health on microRNA levels has the potential to make medicine more precise and personal—especially for people from different racial or ethnic groups who have different social experiences.
What drew you to nursing and research?
I was drawn to nursing because of the holistic perspective on human health. Health outcomes occur as a result of a multitude of factors, including genetic, lifestyle, and environmental. Nurses have always had a focus on meeting a patient at the intersection of their individual combination of these factors to provide optimal care.
I do research and train nurses on the biological and physical functions that take place in the human body. Nurses need to understand these processes to assess health, identify changes, and plan a patient's care with the goal of recovery.
I teach courses on genomics, so my teaching and my research are highly aligned.
Provided by University of California, San Francisco
