Project Summary/Abstract
Cardiometabolic diseases (CMDs), including diabetes and hypertension, impact two-thirds of people in the
United States and are among the leading causes of death worldwide. CMDs lead to devastating consequences
for those afflicated by them, such as the increased risk of vascular and heart disease, leading to future lethal
complications such as myocardial infarction or stroke. Importantly, these conditions do not impact all individuals
equally. CMDs are more prevalent in Hispanics/Latinos, and this population suffers worse complications and
outcomes than non-Hispanic whites. While lifestyle factors and genetic predisposition play a role in CMD
development, the potential contributions of environmental exposures has not been well-established. Starr
County, Texas, is a predominantly Mexican-American community with staggering rages of CMDs, specifically
diabetes mellitus. Interestingly, our preliminary data indicate that metal and metalloid exposures may increase
the risk for CMDs and CMD-related traits in this population. Therefore, we hypothesize that exposure to
metals/metalloids contributes to the observed heightened risk of CMDs in this population. To address this, we
will leverage data from a well-established prospective cohort from Starr County, Texas, a community of >90%
Hispanic/Latino origin. Utilizing already measured urinary metal/metalloid concentrations, we will evaluate
longitudinal cardiovascular and metabolic trajectories of blood pressure, hemoglobin A1c, fasting plasma
glucose, and homostatic measures of assessment for individual metal exposures and metal mixtures in 600
individuals over 3 years. Given the substantial individual and societal burden of CMDs, it is vital to identify
modifiable risk factors in order to empower action for disease prevention, detection, and treatment. Through the
project proposed in this application, valuable insight will be gained into the role of metal/metalloid exposures and
CMD risk in a historically underrepresented population in biomedical research. Lastly, through this proposed
research project and training plan, the applicant for this fellowship will receive comprehensive and
complementary mentorship from a team of experts with a long history of collaboration, numerous opportunities
for publication and presentation of scientific progress, and an overall outstanding education empowering her to
become an independent principal investigator and physician-scientist devoted to improving environmental health
and health justice.