Elena Flowers, PhD, RN
Professor
Physiological Nursing
School of Nursing

My program of research focuses on precision medicine and risk for type 2 diabetes in high risk racial groups. Specifically, I am studying the utility of epigenetic biomarkers for risk detection and prediction of response to risk-reduction interventions. Current studies include investigation of microRNA expression in individuals who are insulin resistant, and prediction of response to both pharmacologic and non-pharmacologic interventions.

Awards

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• Fellow, American Academy of Nursing, 2022
• Fellow, American Heart Association, 2017
• Fellow, Preventive Cardiovascular Nurses Association, 2017
• Martha N. Hill New Investigator Award Finalist, American Heart Association, 2012

Education & Training

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• Ph.D. Nursing University of California, San Francisco 2012
• M.A.S. in Clinical Research Graduate Division (Advanced Training in Clinical Research) University of California, San Francisco 2010
• M.S. Nursing University of California, San Francisco 2007

Websites

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• Posts on X flowers_lab (X.com)
• My Lab Website (elenaflowerslab.ucsf.edu)

Grants and Projects

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• Mentorship of Individuals from Historically Under-Represented Groups in Health Sciences Research, NIH, 2023-2028
• Empirically Based Career Development Program for Historically Under-Represented Early Career Trainees Supported by NIDDK, NIH, 2023-2028
• The Impact of Interventions to Treat Incident Diabetes on Circulating microRNAs in the Diabetes Prevention Program, NIH, 2020-2024
• Evaluating Longitudinal Relationships Between Circulating MicroRNAs and Risk for Type 2 Diabetes and Responses to Behavioral Interventions, NIH, 2018-2021

Publications (71)

Top publication keywords:
Nursing Education ResearchNurse's RoleDiabetes, GestationalPremature BirthCirculating MicroRNAPrediabetic StateDyslipidemiasHypoglycemic AgentsDiabetes Mellitus, Type 2MicroRNAsEducation, Nursing, GraduateDirect-To-Consumer Screening and TestingMetforminBiological PhenomenaFatigue

• Prediabetes Phenotype Clusters in the Diabetes Prevention Program Study.
  bioRxiv : the preprint server for biology 2024 Stroebel BM, Gadgil M, Lewis K, Longoria K, Zhang L, Flowers E
• Corrigendum: Longitudinal associations between microRNAs and weight in the diabetes prevention program.
  Frontiers in endocrinology 2024 Flowers E, Stroebel B, Gong X, Lewis KA, Aouizerat BE, Gadgil M, Kanaya AM, Zhang L
• Addressing Cross-Specialty Clinical Genetics Education Needs.
  The Journal of continuing education in the health professions 2024 Lindquist KJ, Ryan MJ, Scheuner MT, Tamraz B, Flowers E, Harris-Wai J, Biswas S, Hyland K
• Longitudinal associations between microRNAs and weight in the diabetes prevention program.
  Frontiers in endocrinology 2024 Flowers E, Stroebel B, Lewis KA, Aouizerat BE, Gadgil M, Kanaya AM, Zhang L, Gong X
• MicroRNAs Associated with Metformin Treatment in the Diabetes Prevention Program.
  International journal of molecular sciences 2024 Lewis KA, Stroebel BM, Zhang L, Aouizerat B, Mattis AN, Flowers E

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• Multi-Tiered Assessment of Gene Expression Provides Evidence for Mechanisms That Underlie Risk for Type 2 Diabetes.
  Diabetes, metabolic syndrome and obesity : targets and therapy 2023 Asam K, Lewis KA, Kober K, Gong X, Kanaya AM, Aouizerat BE, Flowers E
• MicroRNA biomarkers target genes and pathways associated with type 2 diabetes.
  Diabetes research and clinical practice 2023 Kariuki D, Aouizerat BE, Asam K, Kanaya AM, Zhang L, Florez JC, Flowers E
• MicroRNAs Associated With Incident Diabetes in the Diabetes Prevention Program.
  The Journal of clinical endocrinology and metabolism 2023 Flowers E, Aouizerat BE, Kanaya AM, Florez JC, Gong X, Zhang L
• Review of databases for experimentally validated human microRNA-mRNA interactions.
  Database : the journal of biological databases and curation 2023 Kariuki D, Asam K, Aouizerat BE, Lewis KA, Florez JC, Flowers E
• Prediction of Weight Loss to Decrease the Risk for Type 2 Diabetes Using Multidimensional Data in Filipino Americans: Secondary Analysis.
  JMIR diabetes 2023 Chang L, Fukuoka Y, Aouizerat BE, Zhang L, Flowers E
• Behavioral Analytics for Myopic Agents.
  European journal of operational research 2023 Mintz Y, Aswani A, Kaminsky P, Flowers E, Fukuoka Y
• Systematic review of transcriptome and microRNAome associations with gestational diabetes mellitus.
  Frontiers in endocrinology 2023 Lewis KA, Chang L, Cheung J, Aouizerat BE, Jelliffe-Pawlowski LL, McLemore MR, Piening B, Rand L, Ryckman KK, Flowers E
• Prediction Performance of Feature Selectors and Classifiers on Highly Dimensional Transcriptomic Data for Prediction of Weight Loss in Filipino Americans at Risk for Type 2 Diabetes.
  Biological research for nursing 2023 Chang L, Fukuoka Y, Aouizerat BE, Zhang L, Flowers E
• Healthcare Mistreatment, State-Level Policy Protections, and Healthcare Avoidance Among Gender Minority People.
  Sexuality research & social policy : journal of NSRC : SR & SP 2022 Clark KD, Luong S, Lunn MR, Flowers E, Bahalkeh E, Lubensky ME, Capriotti MR, Obedin-Maliver J, Flentje A
• The Role of Racial and Ethnic Factors in MicroRNA Expression and Risk for Type 2 Diabetes.
  Frontiers in genetics 2022 Flowers E, Kanaya AM, Zhang L, Aouizerat BE
• Co‑expressed microRNAs, target genes and pathways related to metabolism, inflammation and endocrine function in individuals at risk for type 2 diabetes.
  Molecular medicine reports 2022 Flowers E, Asam K, Allen IE, Kanaya AM, Aouizerat BE
• Risk of early birth by body mass index in a propensity score-matched sample: A retrospective cohort study.
  BJOG : an international journal of obstetrics and gynaecology 2022 Baer RJ, Chambers BD, Coleman-Phox K, Flowers E, Fuchs JD, Oltman SP, Scott KA, Ryckman KK, Rand L, Jelliffe-Pawlowski LL
• Serine, N-acetylaspartate differentiate adolescents with juvenile idiopathic arthritis compared with healthy controls: a metabolomics cross-sectional study.
  Pediatric rheumatology online journal 2022 Lewis KA, Osier N, Carrasco R, Chiou J, Carter P, Garcia A, Flowers E, Gennatas ED, Nguyen C, Rana A, Brown SA, Tiziani S
• Consideration of social determinants of health in preterm birth risk and resiliency scoring.
  American Journal of Obstetrics and Gynecology 2022 Rebecca J. Baer, April Bell, Bridgette Blebu, Kimberly Coleman-Phox, Jean Costello, Elena Flowers, Kayla Karvonen, Miriam Kuppermann, Safyer McKenzie-Sampson, Monica McLemore, Scott P. Oltman, Aric …
• Circulating microRNAs are associated with variability in fasting blood glucose over 12-months and target pathways related to type 2 diabetes: A pilot study.
  Diabetes & vascular disease research 2021 Flowers E, Allen IE, Kanaya AM, Aouizerat BE
• Circulating MicroRNAs predict glycemic improvement and response to a behavioral intervention.
  Biomarker research 2021 Flowers E, Allen IE, Kanaya AM, Aouizerat BE
• The association of COVID-19 infection in pregnancy with preterm birth: A retrospective cohort study in California.
  Lancet regional health. Americas 2021 Karasek D, Baer RJ, McLemore MR, Bell AJ, Blebu BE, Casey JA, Coleman-Phox K, Costello JM, Felder JN, Flowers E, Fuchs JD, Gomez AM, Karvonen K, Kuppermann M, Liang L, McKenzie-Sampson S, McCulloch CE…
• 77-OR: Circulating MicroRNAs Predict Glycemic Improvement and Response to a Behavioral Intervention.
  Diabetes 2021 ELENA FLOWERS, ISABEL D. ALLEN, ALKA M. KANAYA, BRADLEY AOUIZERAT
• Socioeconomic status, diabetes, and gestation length in Native American and White women.
  Health psychology : official journal of the Division of Health Psychology, American Psychological Association 2021 Ross KM, Oltman S, Baer R, Altman M, Flowers E, Feuer S, Gomez AM, Jelliffe-Pawlowski L
• Circulating microRNAs associated with prediabetes and geographic location in Latinos.
  International journal of diabetes in developing countries 2021 Flowers E, Ramírez-Mares JD, Velazquez-Villafaña M, Rangel-Salazar R, Sucher A, Kanaya AM, Aouizerat BE, Lazo de la Vega Monroy ML
• Pregnancy after bariatric surgery in women with rheumatic diseases and association with adverse birth outcomes.
  Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery 2020 Singh N, Baer RJ, Swaminathan M, Saurabh S, Sparks JA, Bandoli G, Flowers E, Jelliffe-Pawlowski LL, Ryckman KK
• Nonstationary Bandits with Habituation and Recovery Dynamics.
  Operations Research 2020 Yonatan Mintz, Anil Aswani, Philip Kaminsky, Elena Flowers, Yoshimi Fukuoka
• Direct-to-consumer genomic testing: Are nurses prepared?
  Nursing 2020 Flowers E, Leutwyler H, Shim JK
• Alterations in Patterns of Gene Expression and Perturbed Pathways in the Gut-Brain Axis Are Associated With Chemotherapy-Induced Nausea.
  Journal of pain and symptom management 2020 Singh KP, Dhruva A, Flowers E, Paul SM, Hammer MJ, Wright F, Cartwright F, Conley YP, Melisko M, Levine JD, Miaskowski C, Kober KM
• 855: Risk of adverse birth outcome among Black women with post-traumatic stress disorder.
  American Journal of Obstetrics and Gynecology 2020 Brittany D. Chambers, Rebecca J. Baer, Gretchen Bandoli, Jennifer Felder, Sky K. Feuer, Elena Flowers, Linda Franck, Anu Manchikanti Gomez, Deborah Karasek, Nichole L. Nidey, Scott P. Oltman, …
• Socioeconomic Status, Preeclampsia Risk and Gestational Length in Black and White Women.
  Journal of racial and ethnic health disparities 2019 Ross KM, Dunkel Schetter C, McLemore MR, Chambers BD, Paynter RA, Baer R, Feuer SK, Flowers E, Karasek D, Pantell M, Prather AA, Ryckman K, Jelliffe-Pawlowski L
• 2428-PUB: Circulating microRNAs Are Associated with Latino Ancestry but Not Prediabetes.
  Diabetes 2019 ELENA FLOWERS, MARIA-LUISA LAZO-DE-LA-VEGA-MONROY, ANATOL SUCHER, BRADLEY AOUIZERAT, ALKA M. KANAYA
• 2429-PUB: Circulating microRNAs Are Associated with Glycemic Variability over a 12-Month Period.
  Diabetes 2019 ELENA FLOWERS, ISABEL D. ALLEN, ALKA M. KANAYA, BRADLEY AOUIZERAT
• Pairing pedagogical and genomic advances to prepare advanced practice nurses for the era of precision health.
  BMC medical education 2019 Flowers E, Martin M, Abid H, Binford S, Mackin L
• Body Composition and Diabetes Risk in South Asians: Findings From the MASALA and MESA Studies.
  Diabetes care 2019 Flowers E, Lin F, Kandula NR, Allison M, Carr JJ, Ding J, Shah R, Liu K, Herrington D, Kanaya AM
• Abstract # 2036 Recent stimulant use and leukocyte gene expression in methamphetamine users with treated HIV infection.
  Brain Behavior and Immunity 2019 A.W. Carrico, A. Flentje, K. Kober, S. Lee, P. Hunt, E.D. Riley, S. Shoptaw, E. Flowers, S.E. Dilworth, S. Pahwa, B.E. Aouizerat
• A Pilot Study Using a Multistaged Integrated Analysis of Gene Expression and Methylation to Evaluate Mechanisms for Evening Fatigue in Women Who Received Chemotherapy for Breast Cancer.
  Biological research for nursing 2019 Flowers E, Flentje A, Levine J, Olshen A, Hammer M, Paul S, Conley Y, Miaskowski C, Kober KM
• 695: Recurrence of early preterm, late preterm, and early term birth by race/ethnicity and insurance status.
  American Journal of Obstetrics and Gynecology 2019 Deborah Karasek, Rebecca J. Baer, James G. Anderson, Jennet Arcara, Rachel Berkowitz, Brittany D. Chambers, Sky Feuer, Elena Flowers, Jonathan Fuchs, Anu Manchikanti Gomez, Rita Hamad, Miriam …
• Second trimester inflammatory and metabolic markers in women delivering preterm with and without preeclampsia.
  Journal of perinatology : official journal of the California Perinatal Association 2018 Ross KM, Baer RJ, Ryckman K, Feuer SK, Bandoli G, Chambers C, Flowers E, Liang L, Oltman S, Dunkel Schetter C, Jelliffe-Pawlowski L
• Behavioral Modeling in Weight Loss Interventions.
  European journal of operational research 2018 Aswani A, Kaminsky P, Mintz Y, Flowers E, Fukuoka Y
• Risk Factors Associated With Chemotherapy-Induced Nausea in the Week Before the Next Cycle and Impact of Nausea on Quality of Life Outcomes.
  Journal of pain and symptom management 2018 Singh KP, Kober KM, Dhruva AA, Flowers E, Paul SM, Hammer MJ, Cartwright F, Wright F, Conley YP, Levine JD, Miaskowski C
• Mechanisms and Measurement of Changes in Gene Expression.
  Biological research for nursing 2018 Singh KP, Miaskowski C, Dhruva AA, Flowers E, Kober KM
• Recent stimulant use and leukocyte gene expression in methamphetamine users with treated HIV infection.
  Brain, behavior, and immunity 2018 Carrico AW, Flentje A, Kober K, Lee S, Hunt P, Riley ED, Shoptaw S, Flowers E, Dilworth SE, Pahwa S, Aouizerat BE
• Minority stress and leukocyte gene expression in sexual minority men living with treated HIV infection.
  Brain, behavior, and immunity 2018 Flentje A, Kober KM, Carrico AW, Neilands TB, Flowers E, Heck NC, Aouizerat BE
• Personalizing Mobile Fitness Apps using Reinforcement Learning.
  CEUR workshop proceedings 2018 Zhou M, Mintz Y, Fukuoka Y, Goldberg K, Flowers E, Kaminsky P, Castillejo A, Aswani A
• Evaluating Machine Learning-Based Automated Personalized Daily Step Goals Delivered Through a Mobile Phone App: Randomized Controlled Trial.
  JMIR mHealth and uHealth 2018 Zhou M, Fukuoka Y, Mintz Y, Goldberg K, Kaminsky P, Flowers E, Aswani A
• A review of the literature on the relationships between genetic polymorphisms and chemotherapy-induced nausea and vomiting.
  Critical reviews in oncology/hematology 2017 Singh KP, Dhruva AA, Flowers E, Kober KM, Miaskowski C
• Preliminary evidence supports circulating microRNAs as prognostic biomarkers for type 2 diabetes.
  Obesity science & practice 2017 Flowers E, Kanaya AM, Fukuoka Y, Allen IE, Cooper B, Aouizerat BE
• Serum BDNF Is Positively Associated With Negative Symptoms in Older Adults With Schizophrenia.
  Biological research for nursing 2017 Binford SS, Hubbard EM, Flowers E, Miller BL, Leutwyler H
• Differential expression of genes and differentially perturbed pathways associated with very high evening fatigue in oncology patients receiving chemotherapy.
  Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer 2017 Flowers E, Miaskowski C, Conley Y, Hammer MJ, Levine J, Mastick J, Paul S, Wright F, Kober K
• Abstract P086: Circulating MicroRNAs are Associated with Abdominal Adiposity and Fatty Liver in Asian Indians.
  Circulation 2016 Kevin Miles, Alka M Kanaya, Elena Flowers
• Circulating micrornas associated with glycemic impairment and progression in Asian Indians.
  Biomarker research 2015 Flowers E, Gadgil M, Aouizerat BE, Kanaya AM
• Circulating microRNA-320a and microRNA-486 predict thiazolidinedione response: Moving towards precision health for diabetes prevention.
  Metabolism: clinical and experimental 2015 Flowers E, Aouizerat BE, Abbasi F, Lamendola C, Grove KM, Fukuoka Y, Reaven GM
• Abstract P300: Circulating MicroRNAs Associated with Glycemic Impairment and Progression in Asian Indians.
  Circulation 2015 Elena Flowers, Bradley E Aouizerat, Meghana Gadgil, Alka M Kanaya
• Use of plasma triglyceride/high-density lipoprotein cholesterol ratio to identify increased cardio-metabolic risk in young, healthy South Asians.
  The Indian journal of medical research 2015 Flowers E, Molina C, Mathur A, Reaven GM
• MicroRNAs associated with exercise and diet: a systematic review.
  Physiological genomics 2014 Flowers E, Won GY, Fukuoka Y
• The relationship of lipoprotein(a), C-reactive protein and homocysteine with metabolic syndrome in South Asians.
  Journal of Indian College of Cardiology 2014 Megha Prasad, Elena Flowers, Monica Divakaruni, César Molina, Ashish Mathur, Themistocles L. Assimes, Bradley E. Aouizerat, Anita Sathe, Donna Malhotra, Mintu P. Turakhia
• Effectiveness of a community screening program for metabolic syndrome and cardiovascular risk factor identification in young South Asians adults.
  Diabetes & metabolic syndrome 2014 Prasad M, Flowers E, Mathur A, Sridhar V, Molina C, Turakhia M
• Hyperglycemia is associated with corrected QT prolongation and mortality in acutely ill patients.
  The Journal of cardiovascular nursing 2014 Pickham D, Flowers E, Drew BJ
• SCREENING FOR CARDIOVASCULAR RISK IN YOUNG SOUTH ASIANS: A COMMUNITY BASED STUDY.
  Journal of the American College of Cardiology 2014 Megha Prasad, Elena Flowers, Ashish Mathur, Cesar Molina, Mintu Turakhia
• Abstract P175: Effectiveness Of A Community Screening Program For Metabolic Syndrome And Cardiovascular Risk Factor Identification In Young South Asians Adults.
  Circulation 2014 Megha Prasad, Elena Flowers, Ashish Mathur, Vishaal Sridhar, Cesar Molina, Mintu Turakhia
• MicroRNA associated with dyslipidemia and coronary disease in humans.
  Physiological genomics 2013 Flowers E, Aouizerat BE
• Adiposity and cardiovascular risk clustering in South Asians.
  Metabolic syndrome and related disorders 2013 Flowers E, Molina C, Mathur A, Reaven GM
• MicroRNA associated with atherogenic dyslipidemia in South Asian men.
  International journal of cardiology 2013 Flowers E, Singh K, Molina C, Mathur A, Aouizerat BE
• A culturally specific health coaching program targeting cardiovascular disease risk in South Asians: rationale, design, and baseline data.
  Ethnicity & disease 2013 Sathe A, Flowers E, Mathur A, Garcia DM, Kotrys J, Gandhi R, Molina C, Mathur A
• MicroRNA regulation of lipid metabolism.
  Metabolism: clinical and experimental 2012 Flowers E, Froelicher ES, Aouizerat BE
• Abstract P199: Mean Lipoprotein Levels and Composition in South Asian-Americans Compared to the US Population.
  Circulation 2012 Elena Flowers, Cesar Molina, Ashish Mathur, Bradley Aouizerat, Mintu Turakhia
• Gene-environment interactions in cardiovascular disease.
  European journal of cardiovascular nursing 2012 Flowers E, Froelicher ES, Aouizerat BE
• Measurement of MicroRNA: a regulator of gene expression.
  Biological research for nursing 2011 Flowers E, Froelicher ES, Aouizerat BE
• Prevalence of metabolic syndrome in South Asians residing in the United States.
  Metabolic syndrome and related disorders 2010 Flowers E, Molina C, Mathur A, Prasad M, Abrams L, Sathe A, Malhotra D, Basra R, Malgesini N, Ratnam G, Aouizerat BE, Turakhia MP
• RELATIONSHIP BETWEEN LIPOPROTEIN(A), HOMOCYSTEINE, AND C-REACTIVE PROTEIN AND METABOLIC SYNDROME IN SOUTH ASIAN PATIENTS.
  Journal of the American College of Cardiology 2010 Monica S. Divakaruni, Elena Flowers, Cesar Molina, Ashish Mathur, Megha Prasad, Leslie Abrams, Anita Sathe, Donna Malhotra, Ruby Basra, Gayatri Ratnam, Bradley E. Aouizerat, Mintu P. Turakhia