Susan P Fisher-Hoch

University of Texas Medical School | UTMB · School of Public Health

Background: Adipokines are hormones secreted from adipose tissue and are associated with cardiometabolic diseases (CMD). Functional differences between adipokines (leptin, adiponectin, and resistin) are known, but inconsistently reported associations with CMD and lack of studies in Hispanic populations are research gaps. We investigated the relati...

Endothelial dysfunction assessed by impaired brachial flow-mediated dilation (FMD) predicts incident cardiovascular disease (CVD). We have previously shown that clustering of diabetes mellitus, obesity, and metabolic syndrome in young Hispanic patients was associated with subclinical atherosclerosis. This study aimed to assess determinants of impai...

Minority populations are largely absent from clinical research trials. The neglect of these populations has become increasingly apparent, with escalating cancer burdens and chronic disease. The challenges to recruitment of minorities in the United States are multiple including trust or lack thereof. Keys to successful recruitment are responding to...

Aims/hypothesis The Latino population has been systematically underrepresented in large-scale genetic analyses, and previous studies have relied on the imputation of ungenotyped variants based on the 1000 Genomes (1000G) imputation panel, which results in suboptimal capture of low-frequency or Latino-enriched variants. The National Heart, Lung, and...

Background: Accurately identifying cognitive changes in Mexican American (MA) adults using the Mini-Mental State Examination (MMSE) requires knowledge of population-based norms for the MMSE, a scale which has widespread use in research settings. Objective: To describe the distribution of MMSE scores in a large cohort of MA adults, assess the imp...

Left ventricular hypertrophy (LVH) and concentric LV remodeling (CR) are precursors to development of clinical heart failure (HF), and are associated with obesity, hypertension (HTN) and diabetes mellitus (DM), which are highly prevalent in Mexican Americans. Our study aimed to determine the prevalence of subclinical LV structural abnormalities (LV...

The US prevalence of severe obesity [(SevO), body mass index [BMI] ≥40 kg/m ² )] is increasing at an alarming rate; women and Hispanic Latino populations have experienced among the greatest increases. While genome-wide association studies (GWAS) have identified >1000 loci associated with body mass index, the function of much of this variation is un...

Endothelial dysfunction assessed by impaired brachial flow-mediated dilation (FMD) is a predictive factor of incident CVD. Most studies included small proportions of Hispanics or Latinos. We aimed to assess determinants of impaired FMD in a large population-based sample of asymptomatic Mexican-Americans. Methods: Cardiometabolic biomarkers, viscera...

Background and Aims Whether hepatocellular carcinoma (HCC) increases the familial risk for hepatic fibrosis has not been thoroughly explored, particularly in Mexican Americans who are disproportionately affected by obesity and metabolic syndrome. We evaluated the risk of significant hepatic fibrosis in first‐degree relatives of Mexican American adu...

Context: Some individuals represent forms of "atypical diabetes" (AD) that do not conform to typical features of either type 1 diabetes (T1D) or type 2 diabetes (T2D). These forms of AD display a range of phenotypic characteristics that likely reflect different endotypes based on unique etiologies or pathogenic processes. Objective: To develop a...

Objective: Mexican Americans are disproportionally affected by non-alcoholic fatty liver disease (NAFLD), liver fibrosis and hepatocellular carcinoma. Noninvasive means to identify those in this population at high risk for these diseases are urgently needed. Approach: The Cameron County Hispanic Cohort (CCHC) is a population-based cohort with high...

Background Concurrent variation in adiposity and inflammation suggests potential shared functional pathways and pleiotropic disease underpinning. Yet, exploration of pleiotropy in the context of adiposity-inflammation has been scarce, and none has included self-identified Hispanic/Latino populations. Given the high level of ancestral diversity in H...

The City of Brownsville was made vulnerable to the COVID-19 pandemic due to high rates of obesity and diabetes, high rates of poverty, and adverse social determinants of health. To address the unique challenges faced by the community, Brownsville’s COVID-19 response brought together the skills of academia with the local understanding and health exp...

Background: This retrospective cohort study aimed to examine the interaction effect between puberty stage and weight status on individual and clustering of cardiometabolic risk factors (CMRFs) among Mexican American children and adolescents. A total of 333 children and adolescents (aged 8-18 years) enrolled in the Cameron County Hispanic Cohort (CC...

Background Concurrent variation in adiposity and inflammation suggests potential shared functional pathways and pleiotropic disease underpinning. Yet, exploration of pleiotropy in the context of adiposity-inflammation has been scarce, and none has included self-identified Hispanic/Latino populations. Given the high level of ancestral diversity in H...

Multiple chronic conditions (MCC) are one of the biggest challenges of modern times. The evolution of MCC follows a complex stochastic process that is influenced by a variety of risk factors, ranging from pre-existing conditions to modifiable lifestyle behavioral factors (e.g. diet, exercise habits, tobacco use, alcohol use, etc.) to non-modifiable...

The gut microbiome composition varies across ethnicities and geographical locations, yet studies on diabetes-associated microbiome changes specific to high-risk Mexican Americans are lacking. Here, we aimed to identify specific alterations associated with diabetes in this population, as well as host genetic factors that may explain increased diseas...

Type 2 diabetes is a complex, systemic disease affected by both genetic and environmental factors. Previous research has identified genetic variants associated with type 2 diabetes risk, however gene regulatory changes underlying progression to metabolic dysfunction are still largely unknown. We investigated RNA expression changes that occur during...

More than a quarter of all Americans are estimated to have multiple chronic conditions (MCC). It is known that shared modifiable lifestyle behaviors account for many common MCC. What is not precisely known is the dynamic effect of changes in lifestyle behaviors on the trajectories of MCC emergence. This paper proposes dynamic functional continuous...

Aims Links between resistin, insulin resistance (IR), and resistin-stimulated cytokine signaling remain unknown in Mexican-Americans. A Mexican-American cohort was examined to determine (1) relationships between circulating resistin and IR, (2) resistin’s associations with cytokines and demographic and anthropometric variables, and (3) similar meas...

Background and aims: Hispanics are disproportionately affected by non-alcoholic fatty liver disease, liver fibrosis, cirrhosis, and hepatocellular carcinoma. Preventive strategies and non-invasive means to identify those in this population at high risk for liver fibrosis, are urgently needed. We aimed to characterize the gut microbiome signatures...

COVID-19 vaccination is being rapidly rolled out in the US and many other countries, and it is crucial to provide fast and accurate assessment of vaccination coverage and vaccination gaps to make strategic adjustments promoting vaccine coverage. We reported the effective use of real-time geospatial analysis to identify barriers and gaps in COVID-19...

Hispanics are disproportionally affected by liver fibrosis and hepatocellular carcinoma (HCC). Advanced liver fibrosis is a major risk factor for HCC development. We aimed at identifying somatic mutations in plasma cell-free DNA (cfDNA) of Hispanics with HCC and Hispanics with advanced liver fibrosis but no HCC. Targeted sequencing of over 262 canc...

Background: Hispanics in South Texas have high rates of HCC and NAFLD. Liver fibrosis severity is the strongest predictive factor of NAFLD progression to HCC. We examined the association between free fatty acids (FAs) and advanced liver fibrosis or HCC in this population. Methods: We quantified 45 FAs in plasma of 116 subjects of the Cameron Cou...

Background: US tobacco prevalence estimates often combine Hispanic subgroups, distorting a precise view of specific tobacco use patterns across culturally, geopolitically, and even genetically diverse ethnicities. National and regional data are commonly discordant given the variation in Hispanic samples, and often do not include non-cigarette tobac...

Diabetes is associated with liver disease and risk of hepatocellular carcinoma. In this study, we evaluated the association between liver fibrosis measured by transient elastography and four glucose metabolism measures in the Cameron County Hispanic Cohort, a population-based, randomly selected cohort of Mexican American Hispanics with high rates o...

Background Excess visceral adipose tissue (VAT) is a primary driver for the cardiometabolic complications of obesity; VAT‐associated cardiovascular disease risk varies by race, but most studies have been done on Non‐Hispanics. This study aimed to evaluate the clinical and metabolic correlates of VAT, its association with subclinical atherosclerosis...

Biomarkers to predict risk of liver fibrosis in subjects with nonalcoholic fatty liver disease, a common risk factor for hepatocellular carcinoma, would allow for early preventive interventions. We sought to characterize bile acid profiles associated with liver fibrosis in subjects from the community‐based Cameron County Hispanic Cohort, a populati...

Aims: Over 1/3 of Americans have prediabetes, while 9.4% have type 2 diabetes. The aim of our study was to estimate the prevalence of prediabetes in Mexican Americans, with known 28.2% prevalence of type 2 diabetes, by age and sex and to identify critical socio-demographic and clinical factors associated with prediabetes. Methods: Data were coll...

Pneumococcal strains are variably resistant to killing by neutrophil extracellular traps (NETs). We hypothesize that this variability in resistance is due to heterogeneity in pneumococcal surface protein A (PspA), a structurally diverse virulence factor of Streptococcus pneumoniae. Pneumococcal strains showed variability in induction of NETs and in...

Objective: There is inconsistent evidence and limited data in the Hispanic population concerning fruit and vegetable intake and cancer risk. This study explored the effect of fruit and vegetable intake on cancer risk in Mexican-Americans. Methods: Participants in this cross-sectional study were drawn from the Cameron County Hispanic Cohort. Consump...

Left ventricular diastolic dysfunction (LVDD) and left ventricular hypertrophy (LVH) are key components of clinical diastolic heart failure, and are associated with obesity, hypertension and diabetes mellitus (DM), which are highly prevalent in Mexican Americans. Our study aim was to determine the prevalence of subclinical left ventricular abnormal...

Background Physical activity and sedentary behavior are considered independent risk factors for chronic disease. However, we do not fully understand their interrelation with key health outcomes such as subclinical atherosclerosis. This study examines the combined effects of sedentary behavior and physical activity on carotid intima-media thickness...

Historically, the tobacco industry has marketed directly to minority groups, which is associated with increased product use; the advent of e-cigarettes poses a new risk. The purpose of this study is to examine associations between exposure to tobacco marketing via traditional and digital marketing channels and ever use of e-cigarettes among Mexican...

Objective: No studies so far have shown the effect of fruit and vegetable intake on mental disorders in Mexican Americans, for whom mental illness is an important health issue. This study measured the association of fruit and vegetable intake with the symptoms of cognitive impairment, the indication of increased risk of dementia, anxiety, and depr...

Background: Existing literature has shown racial/ethnic disparities between white and black surgical populations, however, surgical outcomes for Hispanic patients are limited in both scope and quantity. Methods: Data from the American College of Surgeons National Surgical Quality Improvement Program from 2007 to 2015 was used to analyze surgical...

The incidence of hepatocellular carcinoma (HCC) associated with non-alcoholic fatty liver disease (NAFLD) is rapidly increasing. We aimed to elucidate the genetic basis of NAFLD-associated HCC and identify candidate targets for chemoprevention. Twenty HCC tumors, distant liver and matched tails from mice with hepatocytedeletion of Pten (HepPten-) w...

Background & aims: Hepatic fibrosis is a primary risk factor for cirrhosis and hepatocellular carcinoma, which affect a disproportionate number of Hispanics in the United States. We aimed to determine the prevalence of significant fibrosis, measured by point shear-wave elastography (pSWE), and determine characteristics of hepatic fibrosis and simp...

Altered bone quality, caused by underlying metabolic changes of type 2 diabetes (T2D), has been hypothesized to cause altered bone strength and turnover leading to increased fracture risk in T2D patients. Current understanding about changes in bone turnover markers in T2D patients is mainly based on studies focused on Caucasian men and women. Howev...

Introduction: Liver stiffness measured by transient elastography (TE) predicts liver fibrosis progression and risk of hepatocellular carcinoma. Studies have shown associations between liver stiffness and diabetes, insulin resistance, and obesity, independent of steatosis. In this study, we aimed to determine whether glucose control (hemoglobin A1c)...

Background: Epidemiological studies suggest that increased levels of leptin and resistin, and decreased levels of adiponectin are associated with worsening insulin resistance (IR) and atherosclerosis. However, it is unclear if these findings apply to Mexican-Americans, as few have been studied. We examined the relationship of these adipokines and c...

Mexican Americans in south Texas have among highest rates of hepatocellular carcinoma (HCC) in the US. Non-invasive measures of liver fibrosis are needed to identify those at high risk of HCC. The purpose of the study was to determine the prevalence of and factors associated with liver fibrosis using acoustic radiation force impulse (ARFI) elastogr...

Objective Prevalence of type 2 diabetes varies by region and ancestry. However, most guidelines for the prevention of diabetes mellitus (DM) are based on European or non-Hispanic white populations. Two ethnic minority populations—Mexican Americans (MAs) in Texas, USA, and South Indians (SIs) in Tamil Nadu, India—have an increasing prevalence of DM....

We aimed to determine whether aflatoxin dietary exposure plays a role in the high incidence of hepatocellular carcinoma (HCC) observed among Hispanics in South Texas. We measured TP53R249S somatic mutation, hallmark of aflatoxin etiology in HCC, using droplet digital PCR and RFLP. TP53R249S mutation was detected in 3 of 41 HCC tumors from Hispanics...

Background No studies have examined risk factors for the transition from pre-diabetes to diabetes in populations with widespread obesity and diabetes. We determined proximal changes and factors affecting the transition among Mexican-Americans with pre-diabetes. Methods Participants with pre-diabetes (n=285) were recruited from our randomly sampled...

We aimed to determine whether aflatoxin dietary exposure plays a role in the high incidence of hepatocellular carcinoma (HCC) observed among Hispanics in South Texas.We measured TP53R249S somatic mutation, hallmark of aflatoxin etiology in HCC, using droplet digital PCR and restriction fragment length polymorphism. TP53R249S mutation was detected i...

Non-alcoholic fatty liver disease (NAFLD) is considered the hepatic manifestation of the metabolic syndrome, whose criteria are risk factors for atherosclerotic cardiovascular disease. We aimed to evaluate the prevalence of NAFLD, its association with subclinical atherosclerosis, and factors that may account for this association in Mexican American...

Background Chagas disease (Trypanosoma cruzi infection) is the leading cause of non-ischemic dilated cardiomyopathy in Latin America. Texas, particularly the southern region, has compounding factors that could contribute to T. cruzi transmission; however, epidemiologic studies are lacking. The aim of this study was to ascertain the prevalence of T....

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Introduction Hispanic men have higher rates of illness and death from various chronic conditions than do non-Hispanic men. We aimed to characterize the health of Mexican American men living on the US–Mexico border in South Texas and elucidate indications of chronic disease in young men. Methods We sampled all male participants from the Cameron Cou...

Purpose: To measure the association between physical activity and the metabolic syndrome risk in Mexican-Americans. Methods: Participants were drawn from the Cameron County Hispanic Cohort (n = 3,414), a randomly selected Mexican-American cohort in Texas on the US-Mexico border. Moderate and vigorous physical activity was assessed using reliable...

Liver cirrhosis is a leading cause of death in Hispanics and Hispanics who live in South Texas have the highest incidence of liver cancer in the United States. We aimed at determining the prevalence and associated risk factors of cirrhosis in this population. Clinical and demographic variables were extracted for 2466 participants in the community-b...

Purpose . To compare the risk for diabetes in each of 4 categories of metabolic health and BMI. Methods . Participants were drawn from the Cameron County Hispanic Cohort, a randomly selected Mexican American cohort in Texas on the US-Mexico border. Subjects were divided into 4 phenotypes according to metabolic health and BMI: metabolically healthy...

Similar patterns as in Table 1 showed that metabolically unhealthy phenotypes had significantly elevated mean values of total cholesterol, triglycerides, high density lipid cholesterol (HDLC), fasting glucose and insulin, HOMA IR, HbA1c, CRP, and blood pressure compared with metabolically healthy phenotypes. They were more likely to be older, cigar...

Background: Epidemiologic studies have shown that inadequate physical activity was associated with cancers in whites and other ethnic groups, but in Mexican-Americans data are limited. This study aimed to measure the association between physical activity and reported cancer risk in Mexican-Americans. Methods: Participants were drawn from the Cam...

Introduction: We examined the prevalence of depression, obesity, and metabolic syndrome and associations between them in a population-based representative cohort of Mexican Americans living on the United States-Mexico border. Method: The sample in this cross-sectional analysis consisted of 1,768 Mexican American adults (≥ 18 years of age) assess...

Globally half of all diabetes mellitus is undiagnosed. We sought to determine the extent and characteristics of undiagnosed type 2 diabetes mellitus and pre-diabetes in Mexican Americans residing in the United States. This disadvantaged population with 50% lifetime risk of diabetes is a microcosm of the current pandemic. We accessed baseline data b...

Non-communicable diseases (NCDs) are rising among US Hispanics, but few studies have examined the preventive health behaviors for these NCDs among Hispanics. This study compared the preventive health behaviors of smoke-free living, physical activity, fruit and vegetable consumption, and avoidance of heavy alcohol use in Hispanics in the United Stat...

To investigate the potential burden of nonalcoholic steatohepatitis (NASH) and advanced fibrosis in a hispanic community. Four hundred and forty two participants with available ultrasonography data from the Cameron County Hispanic Cohort were included in this study. Each participant completed a comprehensive questionnaire regarding basic demographi...

Despite well-established negative health consequences of smokeless tobacco use (STU), the number and variety of alternative non-combustible tobacco products on the market have increased tremendously over the last 10 years, as has the market share of these products relative to cigarettes. While STU among non-Hispanic white youth has decreased over t...

Background: Disease patterns in Mexican American health-disparity populations differ from larger US populations. Aims: This study is aimed to determine frequency of gastrointestinal cancers in Mexican Americans. Methods: We analyzed self-reported data from the Cameron County Hispanic Cohort where we find high rates of risk factors for cancer:...

Obesity and type 2 diabetes (T2D) are major public health concerns worldwide, and their prevalence has only increased in recent years. Mexican Americans are disproportionately afflicted by obesity and T2D, and rates are even higher in the United States-Mexico border region. To determine the factors associated with the increased risk of T2D, obesity...

Data on the influence of obesity on atherosclerosis in Hispanics are inconsistent, possibly related to varying cardiometabolic risk among obese individuals. We aimed to determine the association of obesity and cardiometabolic risk with subclinical atherosclerosis in Mexican-Americans. Participants (n=503) were drawn from the Cameron County Hispanic...

Background: The global burden of surgical disease has not been well quantified, but is potentially immense. Given the enormity of the problem and the relative paucity of data, definition and monitoring of surgical burden of disease is an essential step in confronting the problem. This study aimed to estimate the prevalence of non-acute surgical di...