<?xml version="1.0" encoding="UTF-8"?><!DOCTYPE article  PUBLIC "-//NLM//DTD Journal Publishing DTD v3.0 20080202//EN" "http://dtd.nlm.nih.gov/publishing/3.0/journalpublishing3.dtd"><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" dtd-version="3.0" xml:lang="en" article-type="research article"><front><journal-meta><journal-id journal-id-type="publisher-id">WJCS</journal-id><journal-title-group><journal-title>World Journal of Cardiovascular Surgery</journal-title></journal-title-group><issn pub-type="epub">2164-3202</issn><publisher><publisher-name>Scientific Research Publishing</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.4236/wjcs.2015.53005</article-id><article-id pub-id-type="publisher-id">WJCS-54317</article-id><article-categories><subj-group subj-group-type="heading"><subject>Articles</subject></subj-group><subj-group subj-group-type="Discipline-v2"><subject>Medicine&amp;Healthcare</subject></subj-group></article-categories><title-group><article-title>
 
 
  Influence of Antirisk Factors of Cardiovascular Diseases on Intracellular Metabolism of Neutrophils in Men with Obesity
 
</article-title></title-group><contrib-group><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>ndrey</surname><given-names>Kratnov</given-names></name><xref ref-type="aff" rid="aff1"><sup>1</sup></xref><xref ref-type="corresp" rid="cor1"><sup>*</sup></xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Elena</surname><given-names>Timganova</given-names></name><xref ref-type="aff" rid="aff1"><sup>1</sup></xref></contrib></contrib-group><aff id="aff1"><addr-line>Department of Therapy, Yaroslavl State Medical University, Yaroslavl, Russia</addr-line></aff><author-notes><corresp id="cor1">* E-mail:<email>kratnov@mail.ru(NK)</email>;</corresp></author-notes><pub-date pub-type="epub"><day>28</day><month>02</month><year>2015</year></pub-date><volume>05</volume><issue>03</issue><fpage>25</fpage><lpage>29</lpage><history><date date-type="received"><day>31</day>	<month>January</month>	<year>2015</year></date><date date-type="rev-recd"><day>accepted</day>	<month>20</month>	<year>February</year>	</date><date date-type="accepted"><day>28</day>	<month>February</month>	<year>2015</year></date></history><permissions><copyright-statement>&#169; Copyright  2014 by authors and Scientific Research Publishing Inc. </copyright-statement><copyright-year>2014</copyright-year><license><license-p>This work is licensed under the Creative Commons Attribution International License (CC BY). http://creativecommons.org/licenses/by/4.0/</license-p></license></permissions><abstract><p>
 
 
  Background: The factor promoting development of oxidative stress at obesity can be the neutro-phils. Objective: To study the influence antirisk factors of cardiovascular diseases on intracellular metabolism of neutrophils in men with peripheral obesity. Methods: In 103 male patients aged 23 to 64 years without coronary heart disease, we studied the presence obesity, antirisk factors of cardiovascular diseases, and the metabolic activity of neutrophils. Results: It is identified that obesity in men associates with more rare use of crude vegetables or fruits every day, and also low physical activity. The daily uses of crude vegetables or fruits, and also the increase of physical activity in obese men promote increase intracellular activity of antioxidative protection at neutrophils. Conclusion: The antirisk factors of cardiovascular diseases increase activity antioxidative protection of neutrophils in men with peripheral obesity, reducing the probability of development of oxidative stress.
 
</p></abstract><kwd-group><kwd>Obesity</kwd><kwd> Neutrophils</kwd><kwd> Reactive Forms of Oxygen</kwd><kwd> Antioxidance</kwd></kwd-group></article-meta></front><body><sec id="s1"><title>1. Introduction</title><p>The data are received that in the USA in 2013, 154.7 million adult people and 23.9 million children are having overweight or obesity [<xref ref-type="bibr" rid="scirp.54317-ref1">1</xref>] . It is believed that by 2015 year approximately 2.3 billion adult people will have overweight and more than 700 million will have obesity. It is shown that the risk of premature death in persons with 40% of overweight is 2 times higher in comparison with the people, who have average body weight [<xref ref-type="bibr" rid="scirp.54317-ref2">2</xref>] .</p><p>Today it is proved, that oxidative stress, caused by non-controlled production of free radicals, plays the important role in the development of atherosclerotic vascular lesions, which is the main cause of development of cardiovascular diseases [<xref ref-type="bibr" rid="scirp.54317-ref3">3</xref>] . The source of active forms of oxygen at obesity belonging to the basic modifiable risk factors of cardiovascular diseases can be the neutrophils. In patients with III degree of obesity, the increase of formation of oxygen radicals of neutrophils is accompanied by the decrease in activity intracellular antioxidative protection that can promote development of oxidative stress [<xref ref-type="bibr" rid="scirp.54317-ref4">4</xref>] . The INTERHEART case―control study, which had the benefit of a very large sample size, in addition to the risk factors of cardiovascular diseases also revealed antirisk factors―sufficient use of vegetables and fruits, regular reception of small doses of alcohol, and regular physical activity [<xref ref-type="bibr" rid="scirp.54317-ref5">5</xref>] .</p><p>The objective was to study the influence of antirisk factors of cardiovascular diseases on intracellular metabolism of neutrophils in men with peripheral obesity without coronary heart disease.</p></sec><sec id="s2"><title>2. Participants and Methods</title><sec id="s2_1"><title>2.1. Participants</title><p>103 male aged 23 to 64 years (mean &#177; SD age: 47.1 &#177; 8.1 years) which were hospitalized in hospital for professional survey have been examined. In order to exclude coronary heart disease in all patients, the electrocardiography was performed, along with bicycle ergometry, Holter electrocardiography monitoring, and echocardiography. For the diagnosis of peripheral obesity, body mass index was calculated. The consumption the crude vegetables or fruits every day, intake of alcohol, physical loadings of medium intensity at work, and employment by sport or presence active leisure in participants by means of questionnaire was studied.</p></sec><sec id="s2_2"><title>2.2. Methods</title><p>The material for this study was peripheral blood analysis which was performed at admission of patients to the hospital with the consent of the Ethical Committee. Neutrophils were isolated from heparinised blood in Ficoll- Verographin double density gradient 1.077 and 1.092 g/cm<sup>3</sup>. The second interface cells contained 95% of neutrophils. The number of neutrophils in the cell suspension was counted in a cell with Goryaev vivo staining with methylene blue in 3% acetic acid (Turk dye) to determine viable cells. Viability of phagocytes, estimated by trypan test was more than 90%. In order to achieve a concentration of 5 &#215; 10<sup>6</sup> neutrophils in 1 ml of cell suspension was diluted with medium 199.</p><p>The test of spontaneous and stimulated nitro blue tetrasolium reduction (NBT-test) was performed by means of quantitative spectrophotometric method using 0.2% nitro blue tetrazolium in phosphate buffer, fixing neu&#173;trophils with methanol and dissolving in mixture of reduced diformazan potassium hydroxide and dimethylsulfoxide 3:5 volume mixture [<xref ref-type="bibr" rid="scirp.54317-ref6">6</xref>] . Suspension of phytohemagglutinin (Phaseolus vulgaris, “PanEco”, USA) was used as inducer of neutrophils redox metabolism.</p><p>Myeloperoxidase activity in neutrophils was studied using a 0.04% solution ortofenilendiamin in phosphate buffer pH 5.0, with the addition of 0.33% hydrogen peroxide solution at a ratio of 20:1 by volume. The reaction was stopped after 10 minutes of 10% sulphuric acid solution. Photometry was carried out at λ = 492 nM [<xref ref-type="bibr" rid="scirp.54317-ref7">7</xref>] .</p><p>The determination of glutatione reductase activity in neutrophils was evaluated by method on degree of oxidation of NADH. In the control and skilled tests containing 0.5 ml of suspension neutrophils 1.5 ml of distilled water, 0.1 ml NADH and 0.3 ml buffer рН 8 was added. The reaction started by addition 0.2 ml of 0.033 mM solution oxidized glutathione. The tests were left at temperature 37˚C for 30 minutes. To stop the reaction the test was placed in refrigerator for 10 minutes at temperature 4˚C. Photometry was carried out at λ = 340 nM [<xref ref-type="bibr" rid="scirp.54317-ref8">8</xref>] .</p><p>The determination of catalase activity in neutrophils was based on the ability of hydrogen peroxide to form salts with molybdenum stable colored complex. The reaction was run by adding 0.03% hydrogen peroxide solution and was stopped after 10 minutes, adding a 4% solution of ammonium molybdate. In control test instead of neutrophils distilled water was brought. The color intensity was measured at λ = 410 nM against a control sample of distilled water [<xref ref-type="bibr" rid="scirp.54317-ref9">9</xref>] .</p></sec><sec id="s2_3"><title>2.3. Statistical Analyses</title><p>Statistical data processing was performed using the package Statistica 8.0 (StatSoft, Inc., USA). The data for categorical variables are expressed as absolute values and percents, and the data for continuous variables are expressed as the median with the 25% - 75% inter quartile range. Differences between groups were considered statistically significant at P &lt; 0.05.</p></sec></sec><sec id="s3"><title>3. Results</title><sec id="s3_1"><title>3.1. General Characteristics of the Study Participants</title><p>Obesity was encountered in 79 (76.7%) evaluable patients, of whom 49 (62%) revealed I degree of obesity (body mass index 30 - 34.9 kg/m<sup>2</sup>), 23 (29.1%)―II degree of obesity (body mass index 35 - 39.9 kg/m<sup>2</sup>), and 7 (8.9%) patients―III degree of obesity (body mass index ≥ 40 kg/m<sup>2</sup>). The 31 (30%) men were used the crude vegetables or fruits every day. The alcohol was taken 97 (94.2%) patients, from which 12 (12.4%) men some times a week and 32 (32.9%) men some times a month was intake. The 92 (89.3%) participant had physical loadings of medium intensity at work, and 32 (31%) men were engaged sport or had active leisure.</p><p>The comparative characteristics of the study participants are presented in <xref ref-type="table" rid="table1">Table 1</xref>. The alcohol some times a month by men with obesity used authentically more often (P &lt; 0.05). Obese men authentically less often had physical loadings of medium intensity at work (P &lt; 0.05), they were engaged sports or had active leisure, and also used the crude vegetables or fruits every day less often.</p></sec><sec id="s3_2"><title>3.2. Characteristics of the Obese Men Depending on the Use of Crude Vegetables or Fruits Every Day</title><p>The use of crude vegetables or fruits every day by men with obesity was accompanied authentically higher parameters of the spontaneous NBT-test (107.8 &gt; 95.7 mM NBT reduced; P = 0.04) and catalase activity (344.3 &gt; 333.7 mCat/l; P = 0.03) at neutrophils (<xref ref-type="table" rid="table2">Table 2</xref>). In men using crude vegetables or fruits every day also was observed authentically lower levels of glucose (4.8 &lt; 5.2 mM/l; P = 0.02) and triglycerides (2 &lt; 2.7 mM/l; P = 0.01) in blood.</p></sec><sec id="s3_3"><title>3.3. Characteristics of the Obese Men Depending on the Employment by Sports or Presence Active Leisure</title><p>In obese men which were engaged sports or had active leisure has been revealed authentically higher glutathione reductase activity (314.9 &gt; 298.8 nM∙l<sup>−</sup><sup>1</sup>∙sec<sup>−</sup><sup>1</sup>; P = 0.01) at neutrophils (<xref ref-type="table" rid="table3">Table 3</xref>), and also lower level of uric acid in blood (6.5 &lt; 7 mg/dl; P = 0.02).</p><p>Presence of physical loadings of medium intensity at work and intake of alcohol did not cause authentically changes of intracellular metabolism of neutrophils.</p><table-wrap id="table1" ><label><xref ref-type="table" rid="table1">Table 1</xref></label><caption><title> Comparative characteristics of the study participants</title></caption><table><tbody><thead><tr><th align="center" valign="middle" >Parameter</th><th align="center" valign="middle" >No Obesity (n = 24)</th><th align="center" valign="middle" >Obesity (n = 79)</th><th align="center" valign="middle" >P</th></tr></thead><tr><td align="center" valign="middle" >The use of crude vegetables or fruits every day</td><td align="center" valign="middle" >8 (33.3)</td><td align="center" valign="middle" >23 (29.1)</td><td align="center" valign="middle" >&gt;0.05</td></tr><tr><td align="center" valign="middle" >The intake of alcohol:</td><td align="center" valign="middle" >22 (91.6)</td><td align="center" valign="middle" >75 (94.9)</td><td align="center" valign="middle" >&gt;0.05</td></tr><tr><td align="center" valign="middle" >- Some times a week</td><td align="center" valign="middle" >3 (13.7)</td><td align="center" valign="middle" >9 (12)</td><td align="center" valign="middle" >&gt;0.05</td></tr><tr><td align="center" valign="middle" >- Some times a month</td><td align="center" valign="middle" >3 (13.7)</td><td align="center" valign="middle" >29 (38.7)</td><td align="center" valign="middle" >0.02</td></tr><tr><td align="center" valign="middle" >Physical loadings of medium intensity at work</td><td align="center" valign="middle" >24 (100)</td><td align="center" valign="middle" >68 (86)</td><td align="center" valign="middle" >0.02</td></tr><tr><td align="center" valign="middle" >Employment by sports or presence active leisure</td><td align="center" valign="middle" >9 (37.5)</td><td align="center" valign="middle" >23 (29.1)</td><td align="center" valign="middle" >&gt;0.05</td></tr></tbody></table></table-wrap><table-wrap id="table2" ><label><xref ref-type="table" rid="table2">Table 2</xref></label><caption><title> Comparative characteristics of the obese men depending on the use of crude vegetables or fruits every day</title></caption><table><tbody><thead><tr><th align="center" valign="middle"  rowspan="2"  >Parameter</th><th align="center" valign="middle"  colspan="2"  >The use of crude vegetables or fruits every day</th><th align="center" valign="middle"  rowspan="2"  >P</th></tr></thead><tr><td align="center" valign="middle" >No (n = 49)</td><td align="center" valign="middle" >Yes (n = 20)</td></tr><tr><td align="center" valign="middle" >Spontaneous NBT-test, mM</td><td align="center" valign="middle" >95.7 (77.8; 107.8)</td><td align="center" valign="middle" >107.8 (94.5; 112.8)</td><td align="center" valign="middle" >0.04</td></tr><tr><td align="center" valign="middle" >Stimulated NBT-test, mM</td><td align="center" valign="middle" >107.1 (88.2; 112.4)</td><td align="center" valign="middle" >108.5 (107.1; 113.5)</td><td align="center" valign="middle" >&gt;0.05</td></tr><tr><td align="center" valign="middle" >Myeloperoxidase, SED</td><td align="center" valign="middle" >5.4 (4; 7.4)</td><td align="center" valign="middle" >5.5 (4.5; 7.7)</td><td align="center" valign="middle" >&gt;0.05</td></tr><tr><td align="center" valign="middle" >Glutatione reductase, nM∙l<sup>−</sup><sup>1</sup>∙sec<sup>−</sup><sup>1</sup></td><td align="center" valign="middle" >302.8 (281.4; 365.8)</td><td align="center" valign="middle" >304.4 (284.8; 366.5)</td><td align="center" valign="middle" >&gt;0.05</td></tr><tr><td align="center" valign="middle" >Catalase, mCat/l</td><td align="center" valign="middle" >333.7 (241.7; 392.9)</td><td align="center" valign="middle" >344.3 (285.8; 400.9)</td><td align="center" valign="middle" >0.03</td></tr></tbody></table></table-wrap><table-wrap id="table3" ><label><xref ref-type="table" rid="table3">Table 3</xref></label><caption><title> Comparative characteristics of the obese men depending on the employment by sports or presence active leisure</title></caption><table><tbody><thead><tr><th align="center" valign="middle"  rowspan="2"  >Parameter</th><th align="center" valign="middle"  colspan="2"  >Employment by sports or presence active leisure</th><th align="center" valign="middle"  rowspan="2"  >P</th></tr></thead><tr><td align="center" valign="middle" >No (n = 46)</td><td align="center" valign="middle" >Yes (n = 23)</td></tr><tr><td align="center" valign="middle" >Spontaneous NBT-test, mM</td><td align="center" valign="middle" >95.7 (78.8; 108.5)</td><td align="center" valign="middle" >106.7 (88.9; 109.2)</td><td align="center" valign="middle" >&gt;0.05</td></tr><tr><td align="center" valign="middle" >Stimulated NBT-test, mM</td><td align="center" valign="middle" >107.8 (94.2; 112.4)</td><td align="center" valign="middle" >108.7 (93.9; 112.9)</td><td align="center" valign="middle" >&gt;0.05</td></tr><tr><td align="center" valign="middle" >Myeloperoxidase, SED</td><td align="center" valign="middle" >5.4 (4; 7.2)</td><td align="center" valign="middle" >5.8 (4.3; 7.5)</td><td align="center" valign="middle" >&gt;0.05</td></tr><tr><td align="center" valign="middle" >Glutatione reductase, nM∙l<sup>−</sup><sup>1</sup>∙sec<sup>−</sup><sup>1</sup></td><td align="center" valign="middle" >298.8 (273.3; 337.7)</td><td align="center" valign="middle" >314.9 (296.1; 393.9)</td><td align="center" valign="middle" >0.01</td></tr><tr><td align="center" valign="middle" >Catalase, mCat/l</td><td align="center" valign="middle" >333.7 (199.8; 382.9)</td><td align="center" valign="middle" >348.3 (302.4; 404.7)</td><td align="center" valign="middle" >&gt;0.05</td></tr></tbody></table></table-wrap></sec></sec><sec id="s4"><title>4. Discussion</title><p>The main argument of an increased interest to obesity is its connection with an atherosclerosis and risk of development of cardiovascular diseases. In recent years growth of heart attacks is observed among youth and people of middle age. Believe that the reason this problem is increase among youth of persons with excessive weight which provokes heart complications. The obesity and hyperglycemia correlate with findings of atherosclerotic plaques in coronary arteries and abdomen part of the aorta in young people at the age of 15 - 34 years [<xref ref-type="bibr" rid="scirp.54317-ref10">10</xref>] . It is shown, that the increase in thickness of complex of intima-media which reflects progressing of atherosclerosis and associates with increase in risk of cardiovascular complications, depends on body weight [<xref ref-type="bibr" rid="scirp.54317-ref11">11</xref>] . Does not cause doubts that in pathophysiology of atherosclerosis play crucial role the subclinical chronic inflammation which present already at early stages. Low oxidative stress modulates in endothelia the expression of the gene inducing atherogenous factor that leads to formation of atherosclerotic plaque. Further existence endothelial oxidative stress conducts to continuous accumulation of lipids, strengthens inflammation, destruction of matrix and remodeling of vascular wall in the atherosclerotic plaque [<xref ref-type="bibr" rid="scirp.54317-ref12">12</xref>] . As adipose tissue produces proinflammatory cytokines, therefore, the obesity can be also considered how inflammation. It is proved, that adipose tissue represents the active metabolic and endocrine organ producing adipocytokines (peptide hormones) and adipokines, one of which―leptin is structurally similar to proinflammatory cytokines―interleukin-6 and interleukin-12. There are data, that leptin stimulates secretion of cytokines and strengthens the expression molecules of adhesion in phagocytes, promotes development of oxidative stress [<xref ref-type="bibr" rid="scirp.54317-ref13">13</xref>] [<xref ref-type="bibr" rid="scirp.54317-ref14">14</xref>] .</p><p>The atherosclerosis is disease with multifactorial etiology, and development of coronary heart disease depends on degree of expressiveness of various factors, which can strengthen each other or act in role of antagonists. Probably that such protective factors as physical activity, antioxidants, and social support can counteract influence of classical risk factors of cardiovascular diseases. It is known, that in regulation of free radical processes in cell play the antioxidative mechanisms, dependent as from antioxidative enzymes, and natural low-mo- lecular formations, which contents in organism of the person is caused by food stuffs. The meta-analysis of numerous researches testifies not only the reduction of antioxidative protection in patients with coronary heart disease, but also the change of its activity depending on smoking, physical activity, and diet [<xref ref-type="bibr" rid="scirp.54317-ref15">15</xref>] . In the present research it is revealed, that men with peripheral obesity less often used of crude vegetables or fruits every day, they had lower physical activity. The use of crude vegetables or fruits every day by obese men was accompanied lower levels of glucose and triglycerides in blood, and also higher antioxidative activity protection at neutrophils. Growth of activity of antioxidative enzymes at neutrophils also was promoted by increase in physical activity in obese men. Results of the research NHANES III, testifying to influence of physical activity on chronic subclinical inflammation, revealed that physical activity back correlates with the quantity of leucocytes and the contents of fibrinogen in blood [<xref ref-type="bibr" rid="scirp.54317-ref16">16</xref>] .</p></sec><sec id="s5"><title>5. Conclusion</title><p>In summary, the use of crude vegetables or fruits every day, and also employment by sports or presence active leisure in men with peripheral obesity promote increase in activity of antioxidative protection at neutrophils, which can reduce the risk of development of oxidative stress.</p></sec></body><back><ref-list><title>References</title><ref id="scirp.54317-ref1"><label>1</label><mixed-citation publication-type="other" xlink:type="simple">Go, A.S., Mozaffarian, D., Roger, V.L., et al. (2013) Heart Disease and Stroke Statistics—2013 Update: A Report from the American Heart Association. Circulation, 127, e6-e245. http://circ.ahajournals.org/lookup/doi/10.1161/CIR.0b013e31828124ad</mixed-citation></ref><ref id="scirp.54317-ref2"><label>2</label><mixed-citation publication-type="other" xlink:type="simple">Malnick, S.D.H. and Knobler, H. (2006) The Medical Complications of Obesity. QJM: An International Journal of Medicine, 99, 565-579. http://dx.doi.org/10.1093/qjmed/hcl085</mixed-citation></ref><ref id="scirp.54317-ref3"><label>3</label><mixed-citation publication-type="other" xlink:type="simple">Heitzer, T., Schlinzig, T., Krohn, K., et al. (2001) Endothelial Dysfunction, Oxidative Stress, and Risk of Cardiovascular Events in Patients with Coronary Artery Disease. Circulation, 104, 2673-2678.http://circ.ahajournals.org/content/104/22/2673.full</mixed-citation></ref><ref id="scirp.54317-ref4"><label>4</label><mixed-citation publication-type="other" xlink:type="simple">Kratnov, A.E. (2014) Activity of Intracellular Metabolism at Neutrophils in Patients with Metabolic Syndrome. Research in Endocrinology, 2014, Article ID: 963868. http://tinyurl.com/nv4vylt</mixed-citation></ref><ref id="scirp.54317-ref5"><label>5</label><mixed-citation publication-type="other" xlink:type="simple">Yusuf, S., Hawken, S., Ounpuu, S., et al. (2004) Effect of Potentially Modifiable Risk Factors Associated with Myocardial Infarction in 52 Countries (the INTERHEART Study): Case-Control Study. Lancet, 364, 937-952. http://dx.doi.org/10.1016/S0140-6736(04)17018-9</mixed-citation></ref><ref id="scirp.54317-ref6"><label>6</label><mixed-citation publication-type="book" xlink:type="simple">Gentle, Т.А. and Thompson, R.А. (1990) Neutrophil Function Tests in Clinical Immunology. In: Gooi, Н.G. and Chapel, Н., Eds., Clinical Immunology. А Practical Approach, 2nd Edition, Oxford University Press, New York.</mixed-citation></ref><ref id="scirp.54317-ref7"><label>7</label><mixed-citation publication-type="other" xlink:type="simple">Saidov, M.Z. and Pinegin, B.V. (1991) Spectrophotometric Analysis of Myeloperoxidase Activity in Phagocytes. Laboratornoe delo, 3, 56-59.</mixed-citation></ref><ref id="scirp.54317-ref8"><label>8</label><mixed-citation publication-type="other" xlink:type="simple">Kratnov, A.E., Potapov, P.P., Vlasova, A.V., et al. (2005) The Activity of Glutathione Reductase in Neutrophils of Patients with Mucoviscidosis. Klinicheskaia laboratornaia diagnostika, 2, 33-36. http://scholar.qsensei.com/content/11s7vg</mixed-citation></ref><ref id="scirp.54317-ref9"><label>9</label><mixed-citation publication-type="other" xlink:type="simple">Mamontova, N.S, Beloborodova, E.I. and Tucalova, L.I. (1994) Activity of Catalase at Chronic Dipsomania. Kliniches-kaia laboratornaia diagnostika, 1, 27-28.</mixed-citation></ref><ref id="scirp.54317-ref10"><label>10</label><mixed-citation publication-type="other" xlink:type="simple">Strong, J.P., Malcom, G.T., McMahan, C.A., et al. (1999) Prevalence and Extent of Atherosclerosis in Adolescents and Young Adults: Implications for Prevention from the Pathobiological Determinants of Atherosclerosis in Youth Study. JAMA, 281, 727-735. http://jamanetwork.com/ on 12/12/2014</mixed-citation></ref><ref id="scirp.54317-ref11"><label>11</label><mixed-citation publication-type="other" xlink:type="simple">Bosevski, M., Georgievska-Ismail, L.J., Tosev, S. and Borozanov, V. (2009) Risk Factors for Development of Peripheral and Carotid Artery Disease among Type 2 Diabetes Patients. Prilozi, 30, 81-90. http://manu.edu.mk/prilozi/5bm.pdf</mixed-citation></ref><ref id="scirp.54317-ref12"><label>12</label><mixed-citation publication-type="other" xlink:type="simple">Spagnoli, L., Bonanno, E., Sangiorgi, G. and Mauriello, A. (2007) Role of Inflammation in Atherosclerosis. Journal of Nuclear Medicine, 48, 1800-1815. http://10.2967/jnumed.107.038661</mixed-citation></ref><ref id="scirp.54317-ref13"><label>13</label><mixed-citation publication-type="other" xlink:type="simple">Das, U.N. (2001) Is Obesity an Inflammatory Condition? Nutrition, 17, 953-966. http://dx.doi.org/10.1016/S0899-9007(01)00672-4</mixed-citation></ref><ref id="scirp.54317-ref14"><label>14</label><mixed-citation publication-type="other" xlink:type="simple">Cave, M.C., Hurt, R.T., Frazier, T.H., Matheson, P.J., Garrison, P.N., McClain, C.J., et al. (2008) Obesity, Inflammation, and the Potential Application of Pharmaconutrition. Nutrition in Clinical Practice, 23, 16-34. http://10.1177/011542650802300116</mixed-citation></ref><ref id="scirp.54317-ref15"><label>15</label><mixed-citation publication-type="other" xlink:type="simple">Flores-Mateo, G., Carrillo-Santisteve, P., Elosua, R., Guallar, E., Marrugat, J., Bleys, J., et al. (2009) Antioxidant Enzyme Activity and Coronary Heart Disease: Meta-Analyses of Observational Studies. American Journal of Epidemiology, 170, 135-147. http://aje.oxfordjournals.org/content/170/2/135.full http://dx.doi.org/10.1093/aje/kwp112</mixed-citation></ref><ref id="scirp.54317-ref16"><label>16</label><mixed-citation publication-type="other" xlink:type="simple">Ford, E.S., Ahluwalia, I.B. and Galuska, D.A. (2000) Social Relationships and Cardiovascular Disease Risk Factors: Findings from the Third National Health and Nutrition Examination Survey. Preventive Medicine, 30, 83-92. http://dx.doi.org/10.1006/pmed.1999.0606</mixed-citation></ref></ref-list></back></article>