Taipei Medical University Institutional Repository:Item 987654321/4389

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(1)! ᆵчᙴᏢεᏢϦӅፁғᄤᔼᎦᏢଣ!! ߥ଼ᔼᎦᏢ‫س‬ᅺγፕЎ!. Master Thesis Graduate Institute of Nutrition & Health Science Taipei Medical University. ໯१ύబууሐᐪഝჹಃ 2 ࠠᑗֿੰ஻‫ޣ‬Ոనғϯॶϐቹៜ. Effect of Dietary Oat plus Chromium on Plasma Biochemical Data in Type 2 Diabetic Patients. ࣴ‫ز‬ғǺᐽ஀࣓ ኗ(Wan-Lin Lu). ࡰᏤ௲௤Ǻᙁ‫܃‬໥റγ(Yi-Wen Chien, Ph.D). ύ๮҇୯ 96 ԃ 1 Д January, 2007.

(2) ύЎᄔा ! ! ߈ Μ ԃ ୯ Γ ᑗֿੰ౰Չ౗೴ԃᚹଯǴᑡ஻ΓαΨВ੻ԃᇸϯǶ໯ १ӧᑗֿੰ‫ݯޑ‬ᕍύ՞Αࡐख़ा‫ޑ‬೽ϩǶࣴ‫ࡰز‬рᑧ१ᠼᆢ፦‫ڀ‬Ԗ‫ۯ‬጗ Ոᑗ΢ϲǴ‫ׯ‬๓Ոિ፦‫ޑ‬ਏ݀ǴԶሐᆶಃ 2 ࠠᑗֿੰ஻‫ޣ‬Ոᑗ‫ޑ‬ፓ࿯Ԗ ᜢǶҁࣴ‫ز‬Ҟ‫ޑ‬ӧಃ 2 ࠠᑗֿੰ஻‫ޑޣ‬໯१ύǴబу֖ሐ‫ޑ‬ᐪഝǴΑှ ჹ‫ځ‬Ոᑗ‫ک‬Ոિ፦‫ޑ‬ቹៜǶ‫ڙ‬၂‫ࣁޣ‬ಃ 2 ࠠᑗֿੰ஻‫ޣ‬Ӆ 14 ՏǴϩࣁჴ ᡍ‫ک‬ჹྣ 2 ಔǴჴᡍಔ‫؂‬Вឪ‫ ڗ‬50 լ‫ޑ‬уሐᐪഝ‫ځ‬ύ֖ሐ 200 ༾լǴჹ ྣಔ߾‫؂‬Вឪ‫ ڗ‬50 լ‫ޑ‬ଳᔿқԯТǴࣁය 8 ຼǶ‫ܭ‬ಃ 0ǵ4ǵ8 ຼԏ໣Ո నኬҁϩ‫݋‬Ǵ໨Ҟхࡴ‫ޜ‬ဎՈᑗǵ໭ࡕՈᑗǵᑗϯՈՅનǵી৞નǵΟ ለҒ‫✊ݨ‬ǵᕴᖌ‫ڰ‬ᎇǵեஏࡋિೈқᖌ‫ڰ‬ᎇǵଯஏࡋિೈқᖌ‫ڰ‬ᎇǶҗ ่݀ᡉҢǴჴᡍಔ‫ޜޑ‬ဎՈᑗᐚࡋǵ໭ࡕՈᑗᐚࡋӧံк 4 ຼ‫ ک‬8 ຼࡕ ᆶჹྣಔКၨԖ಍ी΢ϐৡ౦Ƕჴᡍಔӧံк 4 ຼࡕ‫ޜޑ‬ဎՈᑗᐚࡋ ၨံк߻ਔΠफ़ 7.5%Ǵӧံк 8 ຼࡕ‫ޜޑ‬ဎՈᑗᐚࡋၨံк߻ਔΠफ़ 7.3%Ƕ໭ࡕՈᑗᐚࡋӧံк 4 ຼࡕၨံк߻ਔΠफ़ 11.5%Ǵӧံк 8 ຼࡕ‫ޑ‬໭ࡕՈᑗᐚࡋၨံк߻ਔΠफ़ 10.1%ǶΟለҒ‫✊ݨ‬ǵᕴᖌ‫ڰ‬ᎇǵ եஏࡋિೈқᖌ‫ڰ‬ᎇǵଯஏࡋિೈқᖌ‫ڰ‬ᎇӧံк߻‫ံک‬кࡕࣣคৡ ౦Ǵჴᡍಔ‫ک‬ჹྣಔϐ໔Ψคৡ౦Ƕҗа΢่݀ё‫ޕ‬໯१ύబууሐᐪ ഝჹಃ 2 ࠠᑗֿੰ஻‫ޜޣ‬ဎ‫ک‬໭ࡕՈᑗԖᡉ๱‫ׯޑ‬๓Ƕ ᜢᗖຒ: ಃ 2 ࠠᑗֿੰǵуሐᐪഝǵՈᑗǵՈિ፦. I.

(3) Abstract Many studies have showed a beneficial effect of dietary fiber from delaying glycemic raise and improving blood lipids in type 2 diabetic patients. Some studies have showed chromium as a critical cofactor in the action of insulin. The aim of the study was to investigate the effect of oat plus chromium intake on glycemic responses and lipid profiles in type 2 diabetic patients. We assigned 14 patients with type 2 diabetes to follow two diets each for eight weeks; a diet containing oat 50 gm/day and chromium 200 ȝg/day and a diet containing dried rice 50 gm/day. Venous blood samples were collected form subjects during the fasting and 120 minutes after breakfast at weeks 0, 4, 8. We compared the effects of the two diets on glycemic control and plasma lipid concentrations. In the oat plus chromium group, the levels of fasting glucose had decreased by 7.5% after 4 weeks. The levels of fasting glucose had decreased by 7.3% in the oat plus chromium group after 8 weeks. The levels of postprandial glucose had decreased by 11.5% in the oat plus chromium group after 4 weeks. The levels of postprandial glucose had decreased by 10% in the oat plus chromium group after 8 weeks. There were significant differences between the oat plus chromium group and the dried rice group. The levels of insulin, glycosylated hemoglobin were no significant difference between weeks 0, 4, 8. The levels of plasma total cholesterol, triglyceride, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol were no significant difference between weeks 0, 4 ,8 . There were no significant difference between two group on lipid levels. As the results that consumption of oat plus chromium could improve the glycemic response in type 2 diabetic patients. II.

(4) Key words: type 2 diabetic patients, oat plus chromium, fasting glucose, postprandial glucose, plasma lipids. III.

(5) ठᖴ Ꮲ཰ಖ‫֋ܭ‬΋ࢤပǴૈ୼໩ճ‫ޑ‬౥཰ाགᖴ‫ޑ‬ΓϼӭΑǴ२ӃाӃ གᖴ‫ࡰޑךࢂޑ‬Ꮴ௲௤ᙁ‫܃‬໥ԴৣǴӴ๏‫ך‬೚ӭ‫ࡰޑ‬Ꮴᆶ‫ڐ‬շǴҁፕЎ ωૈ໩ճֹԋǶΨགᖴчᙴླྀનঙԴৣ‫ک‬ჴ፬εᏢ໳ඁӹԴৣ‫ޑ‬ಒЈቩ ࢗኘϧࡰ҅Ǵ٬ளҁፕЎ‫׳‬ᑪֹഢǴӆԜ΋‫ٳ‬ठ΢നు‫ޑ‬ᖴཀǶ! ӕਔགᖴ‫܌‬Ԗ‫س‬΢Դৣॺ‫ޑ‬஼Ј௲Ꮴᆶፌፌ௲ᇧǴ٬‫ך‬ӧᏢ཰ǵғ ࢲ΢ᕇ੻‫ؼ‬ӭǶΨᖴᖴ೚ӭᏢ‫کۊ‬Ꮲ‫ޑۂ׌‬ᔅԆǶќѦᖴᖴ٫਱१ࠔި ҽԖज़Ϧљග‫࣬ٮ‬ᜢ࿶຤‫ڐک‬շǴ٬ჴᡍ໩ճֹԋǶᗋाགᖴഋӀЎୋ ଣߏ‫ޑ‬εΚЍ࡭‫ࡰک‬ᏤǴΨགᖴᙴଣ‫ޑ‬ӕ٣Ǵόᆅӧ୦ਜය໔‫଺܈‬ჴᡍ ය໔೿๏ϒ‫ך‬೚ӭᔅշǶ! നࡕाགᖴ‫ࢂޑ‬ৎΓ‫ޑ‬Ѝ࡭ᆶႴᓰǴЀ‫ࢂځ‬ӃғРঋ҆ᙍྣ៝ 3 ঁ λ࠸ᡣ‫ך‬คࡕ៝ϐኁǶᕴϐӆԛགᖴ‫܌‬Ԗ‫ڐ‬շၸ‫ޑך‬ΓǴᖴᖴεৎǶ!. IV.

(6) Ҟᒵ ।ኧ ύЎᄔा……………………………………………………….…….…. I मЎᄔा………………………………………………………….….…. II ठᖴ……………………………………………………………………... ˪ Ҟᒵ………………………………………………….………………….. ˫ ߄Ҟԛ………………………………………………………...………….˭ ಃ΋ക ᆣፕ…………....………………………………………….……. 1 ಃ΋࿯ ࣴ‫୏ز‬ᐒ…………………..….…...……...………………..1 ಃΒ࿯ ࣴ‫ز‬Ҟ‫…………………ޑ‬..….…...……...………………..3 ಃΒക Ў᝘ӣ៝ ಃ΋࿯ ᑗֿੰ‫ੰޑ‬Ӣ‫ک‬ϩᜪ….……………..……………….….. 4 ಃΒ࿯ ᑗֿੰ‫ޑ‬໯१ࡌ᝼ ………………..….…...……...………9 ಃΟ࿯ ᑧ१ᠼᆢ፦ᆶᑗֿੰ……………………………………..12 ಃѤ࿯ ሐᆶᑗֿੰ……………………….…….………….……...16 ಃΟക ‫׷‬਑ᆶБ‫ݤ‬ ಃ΋࿯ ‫ڙ‬၂‫……………………………………………………ޣ‬..18 ಃΒ࿯ ჴᡍࢬำ‫ک‬೛ी…………………………………………..19 ಃΟ࿯ ၗ਑ԏ໣‫ک‬ϩ‫݋‬Б‫…………………………ݤ‬...………...21. V.

(7) ಃѤ࿯ ಍ीᆶϩ‫……………………………………………݋‬......29 ಃѤക ่݀ ಃ΋࿯ ‫ڙ‬၂‫୷ޣ‬ҁၗ਑…………………………………….…….30 ಃΒ࿯ ‫ڙ‬၂‫ޣ‬ᡏՏ‫ׯޑ‬ᡂ…………………………………..........31 ಃΟ࿯ ‫ڙ‬၂‫ޣ‬ϐ໯१ϩ‫………………………………………݋‬..32 ಃѤ࿯ Ոᑗǵી৞ન‫ک‬ᑗϯՈՅન‫ׯޑ‬ᡂ………….…….....33 ಃϖ࿯ Ոિ፦ᐚࡋ‫ׯޑ‬ᡂ………………..……………...……..35 ಃϤ࿯ ჹ‫ط‬фૈࡰኧ‫ޑ‬ቹៜ…………………………………..37 ಃΎ࿯ ჹ๝фૈࡰኧ‫ֿک‬ለ‫ޑ‬ቹៜ…………………….…….38 ಃϖക૸ፕ ಃ΋࿯ ‫ڙ‬၂‫ޣ‬ᡏՏ‫ׯޑ‬ᡂ‫ک‬໯१ឪ‫ڗ‬௃‫………׎‬..……………39 ಃΒ࿯ Ոᑗϐᡂϯ………………………………………….…….41 ಃΟ࿯ Ոિ፦ϐᡂϯ……………………………………………..43 ಃϤക ่ፕ …………….…………………………………....………...45 ୖԵЎ᝘……………………………………………………..….……….46. VI.

(8) ߄Ҟԛ ।ኧ ߄΋ ᐪഝТԋϩ…………………………………………………...57 ߄Β ‫ڙ‬၂‫ံޣ‬к߻୷ҁၗ਑………………………………...……58 ߄Ο ‫ڙ‬၂‫ޣ‬ϐᡏख़ǵ‫ي‬ᡏ፦ໆࡰኧǵᡏિެ…………………...59 ߄Ѥ ዗ໆϷΟεᔼᎦનϐѳ֡ឪ‫ڗ‬ໆ……………………….…..60 ߄ϖ ‫ڙ‬၂‫ޣ‬ϐՈᑗǵી৞ન‫ک‬ᑗϯՈՅન………………...……61 ߄Ϥ ‫ڙ‬၂‫ޣ‬ϐՈિ፦ᐚࡋ……….………………………………..62 ߄Ύ уሐᐪഝჹ‫ڙ‬၂‫طޣ‬фૈϐቹៜ………………...................63 ߄Ζ уሐᐪഝჹ‫ڙ‬၂‫ޣ‬๝фૈ‫ֿک‬ለϐቹៜ…………….…......64. VII.

(9) ಃ΋ക ᆣፕ ಃ΋࿯!ࣴ‫୏ز‬ᐒ! ᑗֿੰҞ߻ςࣁӄౚଯᑡ஻౗‫ޑ‬ᄌ‫ੰ܄‬ϐ΋ǴਥᏵՉࡹଣፁғ࿿ ‫ޑ‬಍ीǴᑗֿੰவ 1979 ԃаࡕǴҗΜεԝΫচӢ‫ޑ‬ಃϖՏǴҞ߻‫៌׳‬ϲ ҇୯ 94 ԃѠ᡼Ӧ୔ΜεԝΫচӢύ‫ޑ‬ಃѤՏǴ‫ ؂‬10 ࿤ΓαԝΫ౗ 46.2%ǴԝΫ౗ࣁ 7.6%Ȑ҇୯ 94 ԃǴՉࡹଣፁғ࿿ȑǶҗ‫ܭ‬ғࢲНྗග ଯǴғࢲಞᄍᆶ໯१Ўϯ‫ׯޑ‬ᡂǴᑗֿੰΓαԖВᅌቚӭ‫ޑ‬ᖿ༈Ƕ 1993-1996 ԃ‫ޑ‬୯҇ᔼᎦ଼ந‫ݩރ‬ᡂᎂፓࢗύǴ௦Ҕऍ୯ᑗֿੰᏢ཮ 1997 ԃว߄ϐບᘐ኱ྗǴว౜ 19 ྃа΢‫ޑ܄ت‬ᑗֿੰ౰Չ౗ࣁ 3.7%Ǵζ‫ࣁ܄‬ 6.3%ǹ45 ྃа΢‫ ࣁ܄ت‬7.9%Ǵζ‫ ࣁ܄‬17.3%ǹ65 ྃа΢‫ ࣁ܄ت‬7.8%Ǵ ζ‫ ࣁ܄‬19.6% (Pan et al., 2003)ǶҞ߻Ѡ᡼՗ी߈ 100 ࿤ᑗֿੰΓǴԶԃ សλ‫ ܭ‬30 ྃ‫ޑ‬ಃ 2 ࠠᑗֿੰΓэԋԃΓᑗֿੰ௼ဂϐК‫ ࣁٯ‬0.5% (Chuang et al., 2006)Ƕ ᑗֿੰό໻੯ੰҁ‫ي‬Ǵ‫ځ‬ᄌ‫ٳޑ܄‬วੱς࿶ᝄख़‫ޑ‬ቹៜ‫ډ‬୯Γ‫଼ޑ‬ நǴԶᑗֿੰӵ݀ؒԖ‫ؼ‬ӳ‫ޑ‬௓‫ڋ‬Ǵ཮Їଆ࡚‫ٳ܄‬วੱӵᑗֿੰ✉ለύ ࢥǵଯᅖ೸ᓸଯՈᑗߚ✉ለ‫ܶ܄‬଎‫܈‬եՈᑗϸᔈǴаϷᄌ‫ٳ܄‬วੱӵЈ Ոᆅ੯ੰǵ๝фૈੰᡂǵѨܴǵᄒަ฻Ǵ೿཮஥๏‫཮ޗ‬୯ৎѮε‫ޑ‬࿶ᔮ ‫଼ک‬ந‫ޑ‬ཞѨǶ ᑗֿੰ‫ݯޑ‬ᕍѸ໪‫ݙ‬ཀ໯१ǵၮ୏Ϸᛰ‫࣬ޑނ‬ϕଛӝǴԶ‫ځ‬ύ໯१. 1.

(10) ௓‫࣬ࣁڋ‬྽ख़ा‫ޑ‬΋ᕉǶᛰ‫ނ‬ᗨࣁ௓‫ڋ‬ᑗֿੰനදၹ‫ޑ‬Б‫ݤ‬Ǵՠᛰ‫ނ‬௓ ‫ޑڋ‬ӕਔǴ௓‫ڋ‬໯१Ψࢂόё۹ຎ‫ޑ‬Ƕӵ݀ؒԖ፾྽‫ޑ‬໯१ଛӝǴᛰ‫ނ‬ Ψค‫ݤ‬วච‫ځ‬ਏ݀Ǵаၲ‫ډ‬௓‫ؼڋ‬ӳՈᑗ‫ޑ‬Ҟ‫ޑ‬Ƕ໯१‫ݯ‬ᕍ‫ޑ‬Ҟ‫ࢂޑ‬а ֡ᑽ໯१ࣁ୷ᘵǴаၲ‫ډ‬Ոᑗᖿ߈҅தॶǵᆢ࡭౛གྷᡏख़ϷՈિ፦҅த ‫ޑ‬Ҟ኱ǶӵՖճҔ໯१‫ݯ‬ᕍ٬Ոᑗள‫ࡐډ‬ӳ‫ޑ‬௓‫ڋ‬Ǵࢂ‫ݯ‬ᕍᑗֿੰਔന ख़ा‫ޑ‬ፐᚒǶ ߈ԃٰǴ೚ӭࣴ‫่݀ز‬ᡉҢᑧ१ᠼᆢ፦‫ک‬ᑗֿੰϐᜢ߯ߚதஏϪǶ Ԗࣴ‫ز‬᛾ჴǴቚу໯१ύӄ⟻ᜪϷ⟻ᜪᠼᆢ‫ޑ‬ឪ‫ڗ‬ໆǴёफ़եᑗֿੰ‫ޑ‬ ᑡ஻౗(Meyer et al., 2000)ǴӢࣁᑧ१ᠼᆢ፦ё‫ۯ‬጗१‫੃ޑނ‬ϯ֎ԏǴ‫ׯ‬ ๓໭ࡕՈᑗϸᔈϷી৞નᐚࡋǴफ़եી৞ન‫(܄ל‬insulin resistance)Ϸ‫ׯ‬๓ ဟ๻ᑗϐऐ‫(܄ڙ‬glucose tolerance) (Hallfrisch et al., 2000)ǶќԖࣴ‫ࡰز‬р ൤֖Нྋ‫܄‬ᠼᆢ፦‫ޑ‬ᐪഝёа‫ۯ‬጗Ոᑗ‫ޑ‬΢ϲǴԖշ‫ܭ‬௓‫ڋ‬Ոᑗ(Bratten et al., 1991)Ƕ ନԜϐѦǴᆶᑗֿੰԖᜢ‫ޑ‬ӢηᗋԖ༾ໆϡનύ‫ޑ‬ΟሽሐǴΟሽሐ ࣁဟ๻ᑗऐ‫ڙ‬ӢηȰglucose tolerance factorǴGTFȱ‫ޑ‬ԋϩϐ΋Ǵჹ‫ܭ‬Ո ᑗ‫ޑ‬ፓ࿯ҭ‫ת‬ᄽख़ा‫فޑ‬ՅǴа۳‫زࣴޑ‬ӭࢂаံкᏊ‫׎‬Ԅ຾ՉǴҁࣴ ‫ز‬ीฝ‫ޑ‬Ҟ‫߾ޑ‬ӧ‫ܭ‬ճҔ֖ሐ‫ޑ‬ᐪഝǴబу‫ܭ‬ᑗֿੰੰ஻‫ޑޣ‬໯१ϐ ύǴ຾ՉΓᡏ၂ᡍǴ௖૸ჹ‫ځ‬ՈિǵՈᑗ฻‫ޑ‬ቹៜǶ. 2.

(11) ಃΒ࿯ ࣴ‫ز‬Ҟ‫ޑ‬ ΋ǵ௖૸уሐᐪഝჹಃ 3 ࠠᑗֿੰ஻‫ޣ‬Ոᑗ‫ޑ‬ቹៜǶ. Βǵ௖૸уሐᐪഝჹಃ 3 ࠠᑗֿੰ஻‫ޣ‬Ոિ፦‫ޑ‬ቹៜǶ Οǵ௖૸ಃ 3 ࠠᑗֿੰ஻‫ځ‬዗ໆ‫ک‬ᔼᎦનឪ‫ڗ‬ໆ‫ޑ‬௃‫ݩ‬Ƕ. 3.

(12) ಃΒക Ў᝘ӣ៝ ಃ΋࿯ ᑗֿੰ‫ੰޑ‬Ӣ‫ک‬ϩᜪ ᑗֿੰ( diabetes mellitusǹDM )ࢂ΋ᅿߏයՈᑗၸଯϐ੯ੰǴӢࣁ‫ي‬ ᡏύી᠌ϣើМλ৞‫نޑ‬Ѭಒझ( ȕ-cell )ค‫ݤ‬ϩ‫୼ىݜ‬ኧໆ‫ޑ‬ી৞નǴ‫܈‬ ᡏϣી৞નόૈวච‫ځ‬ғ౛фૈਔǴ‫܌‬Ꮴठ‫ޑ‬Ոᑗၸଯ‫ޑ‬੯ੰǶ ‫׎‬ԋᑗֿੰ‫ޑ‬চӢߚதፄᚇǴ٠ߚ΋ᅿൂ΋চӢ‫ޑ‬੯ੰǴԶࢂ‫ڀ‬Ԗ ӭᅿੰӢ‫ޑ‬੯ੰ( DeFronzo , 1998 )ǶҞ߻‫ޕ‬ၰёૈᆶৎ௼ᒪ໺ǵԾᡏխ ࣝǵ‫ޥ‬औ฻ӢηԖᜢǶന߈‫زࣴޑ‬ว౜ᡏϣԾҗ୷ࢲ‫ک܄‬િ፦ၸ਼ϯౢ‫ނ‬ ‫ޑ‬ቚуᆶ‫਼ל‬ϯٛᑇ‫س‬಍໔όѳᑽ‫܌‬Їว‫਼ޑ‬ϯ໾্ǴӧᑗֿੰϷ‫ٳځ‬ วੱ΢ҭёૈ‫ת‬ᄽ๱ख़ा‫ف‬Յ( Oberly , 1988ǹBaynes et al., 1991 )Ƕ ӧ 1979 ԃऍ୯୯ৎፁғଣ(National Institute of HealthǹNIH)Ԗ᠘‫ܭ‬ᑗ ֿੰϩᜪࠠԄ‫ޑ‬ό಍΋Ǵ੝ձҗ୯ৎᑗֿੰၗ਑ಔ(National Diabetes Data Group, NDDG)ख़ཥᘜᜪǴஒᑗֿੰϩࣁಃ΋ࠠᑗֿੰ(Type ˧diabetes)ǵ ಃΒࠠᑗֿੰ(Type ˨diabetes)ǵԛว‫܄‬ᑗֿੰ)diabetes secondary)!ǵဟ ๻ ᑗ ऐ ໆ ౦ த (impaired glucose tolerance)! ǵ ֳ ৄ ᑗ ֿ ੰ )gestational diabetes,GD* Ƕ1985 ԃҗШࣚፁғಔᙃ( World Health OrganizationǹWHO) অुԋࣁǺ 1. ી৞ન٩ᒘࠠᑗֿੰ(insulin-dependent diabetes mellitusǹ IDDM) 2. ߚ ી ৞ ન ٩ ᒘ ࠠ ᑗ ֿ ੰ (non-insulin-dependent diabetes 4.

(13) mellitusǹNIDDM) 3. ᔼᎦѨፓ‫܄‬ᑗֿੰ(malnutrition-related diabetes mellitusǹ MRDM) 4. ֳৄᑗֿੰ(gestational diabetes mellitusǹGDM) 5. ‫ځ‬дࠠᑗֿੰ (1) ી᠌੯ੰ (2) ϣϩ‫ݜ‬੯ੰ (3) ᛰ‫܈ނ‬ϯᏢ‫ࠔނ‬Їଆ‫ޣ‬ (4) ી৞નௗ‫ڙ‬Ꮤ౦த‫ޣ‬ (5) ࢌ٤ᒪ໺ੱংဂ 1997 ԃऍ୯ᑗֿੰᏢ཮ࡌ᝼аੰӢբࣁᑗֿੰ‫ޑ‬ϩᜪǴϩձаಃ 1 ࠠᑗֿੰ(Type 1 diabetes mellitus)Ϸಃ 2 ࠠᑗֿੰ( Type 2 diabetes mellitus) ‫ ڗ‬ж ી ৞ ન ٩ ᒘ ࠠ ᑗ ֿ ੰ (IDDM) ᆶ ߚ ી ৞ ન ٩ ᒘ ࠠ ᑗ ֿ ੰ (NIDDM) ǴЪஒᑗֿੰϩᜪ၁у୔ϩӵΠ(ADA, 2001)Ǻ 1.ಃ 1 ࠠᑗֿੰ(Type 1 diabetes mellitus) җ‫ܭ‬ી᠌‫ن‬Ѭಒझ೏ઇᚯǴᏤठી৞નલЮ (1)խࣝ൞ϟࠠ(immune mediated) (2)੝วࠠ(idiopathic) 2.ಃ 2 ࠠᑗֿੰ( Type 2 diabetes mellitus) хࡴ߃ය‫ޑ‬Ьाჹી৞નԖ࡮‫܄ל‬٠Ԗી৞ન࣬ჹ‫܄‬લЮ 5.

(14) ‫ੰޑ‬ΓǴԿఁයЬाࣁી৞નϩ‫ݜ‬ό‫ى‬ӝ‫ٳ‬ી৞ન࡮‫ੰޑל‬ ΓǶ 3.‫ځ‬д੝౦ᜪࠠ (1) ‫ن‬Ѭಒझфૈ‫୷ޑ‬Ӣલഐ:ӵಃ 12 ჹࢉՅᡏǴ‫ط‬ಒझਡ Ӣη 1-Į(chromosome 12ǹHNF-1Į)ǵ ಃ 7 ჹࢉՅᡏǴဟ ๻ᑗᐟ䁙(chromosome 7ǹglucokinase) ǵಃ 20 ჹࢉՅᡏǴ ‫ط‬ಒझਡӢη 4-Į(chromosome 20ǹHNF-4Į)!ǵಈጕᡏѐ ਼ਡᑗਡለ(mitochondrial DNA) Ƕ (2) ી৞નࢲ‫୷܄‬Ӣલഐ:ӵ A ࠠી৞નߔ‫(ל‬type A insulin resistance)! ǵ ࿖ ֯ ᆒ ᇮ ੱ ং )Leprechaunism) ǵ ੱ. Rabson-Mendenhall. ং. ဂ. (Rabson-Mendenhall. syndrome)!ǵિ๺ᕭ‫܄‬ᑗֿੰ(lipoatrophic diabetes) Ƕ (3)Ѧϩ‫ݜ‬ી᠌‫ޑ‬੯ੰ(diseases of the exocrine pancreases) х ࡴ : ી ᠌ ‫( ݹ‬pancreatitis)! ǵ ബ ໾ / ી ᠌ Ϫ ନ (trauma/pancreatectomy)!ǵဍዦ(neoplasia)!ǵᠼᆢ‫៶܄‬ဍ (cystic fibrosis)!ǵՈՅન؈๱ੱ(hemochromatosis)!ǵᠼ ᆢ້ϯ‫܄‬ી᠌ੰᡂ(fibrocalculous pancreatopathy) Ƕ (4) ϣ ϩ ‫ ੰ ݜ‬ᡂ (endocrinopathies) х ࡴ : ަ ᆄ ‫ ޥ‬ε ੱ (acromegaly)!ǵ৤‫ݒ‬Мੱংဂ (Cushing syndrome)!ǵϲ. 6.

(15) ᑗ. ન. ዦ. (glucagonoma). ǵ. ༐. ሐ. ಒ. झ. ዦ. (pheochromocytoma)!ǵҘ‫ރ‬ဏϗ຾(hyperthyroidism)!ǵ ᡏ‫׭‬નዦ (somatostatinoma)!ǵ⾺‫✉ڰ‬ዦ(aldosteronoma) Ƕ (5)ᛰ‫܈ނ‬ϯᏢ‫ނ‬፦ᇨวхࡴ: VactorǵPentamidineǵ๨ᡵન (nicotinic acid)!ǵᑗҜ፦ન(glucocorticoids)!ǵҘ‫ރ‬ဏᐟ ન (thyroid hormone) ǵ Diazoxide ǵ ๝ ΢ ဏ ન ߦ ਏ Ꮚ (ȕ-adrenergic agonists)!ǵThiazidesǵDilantinǵĮ υᘋન (Į-interferon)Ƕ (6)གࢉхࡴ: ቺ୯ഞ੶(congenital rubella)!ǵѮಒझੰࢥ (cytomegalovirus) Ƕ (7) ό ൨ த ࠠ Ԅ ‫ ޑ‬խ ࣝ ൞ ϟ ‫ ޑ‬ᑗ ֿ ੰ : ฽ ‫ ޔ‬Γ ੱ ং ဂ (Stiff-man syndrome)!ǵ‫ל‬ી৞ન‫ڙ‬Ꮤ‫ל‬ᡏ(anti-insulin receptor antibodies) Ƕ (8)Ԗਔӝ‫ٳ‬ᑗֿੰ‫ځޑ‬дᒪ໺ੱংဂ:ঞМੱংဂ (Down’s syndrome) ǵ Klinefelter М ੱ ং ဂ (Klinefelter’s syndrome)ǵWolfram Мੱংဂ(Wolfram’s syndrome)ǵ Turner Мੱংဂ(Turner’s syndrome)ǵFriedreich Мၮ୏Ѩ ፓ(Friedreich’s ataxia)ǵHuntington Мᆸᗂੱ)Huntington’s chorea)ǵLaurence-moon-Biedl Мੱ)Laurence-moon-Biedl. 7.

(16) syndrome) ǵ Լ ம ‫ ܄ ޔ‬Ѩ Ꭶ ੱ )Myotonic muscular dystrophy) ǵ ๋ ፦ ੱ )porphria) ǵ Prader-Willi М ੱ ং ဂ )Prader-Willi syndrome) Ƕ 4.ֳৄᑗֿੰ(gestational diabetes mellitusǹGDM) ୯Γᑗֿੰ஻๊εӭኧឦ‫ܭ‬ಃ 2 ࠠǴӭӧ 50 ྃаࡕǴᑗֿੰ௓‫ޑڋ‬ ᆶց٠ό‫ޔ‬ௗቹៜғԝǴՠᆶ‫ٳ‬วੱǵғࢲࠔ፦ࠅԖᜢᖄǶᑗֿੰ‫ٳޑ‬ วੱёϩࣁ࡚‫ک܄‬ᄌ‫ٿ܄‬εᜪǴ࡚‫ٳ܄‬วੱхࡴᑗֿੰ✉ለύࢥ( diabetic ketoacidosis, DKA) ǵ ଯ Ո ᑗ ଯ ᅖ ೸ ᓸ ߚ ✉ ᡏ ‫ ܶ ܄‬଎ ( hyperglycemic hyperosmolar nonketotic coma, HHNK) ǵեՈᑗǶᄌ‫ٳ܄‬วੱхࡴຎᆛጢ ੰᡂǵᑗֿੰ๝ੰᡂǵᑗֿੰઓ࿶ੰᡂǵεՈᆅੰᡂ( ߷ЈੰǵတՈᆅੰ ᡂǵຼᜐՈᆅ੯ੰ) Ƕ٩ 1998 ԃ଼ߥၗ਑ǴᑗֿੰੰΓ઻຤଼ߥၗྍ 11.5%Ǵѳ֡ᙴᕍ޸຤ࣁߚᑗֿੰੰΓ‫ ޑ‬4.3 ७(Lin et al., 2001)ǶӢԜ୯ ଼҇நֽᇶᏤӚᑜѱࡌҥᑗֿੰӅӕྣៈᆛǴ൩ࢂҾკᙴৣࣁЬᏤ᏾ӝ ᙴᕍი໗Ǵуம੯ੰᆅ౛аቚ຾ғࢲࠔ፦Ϸ࿯࣪ᙴᕍ຤Ƕ. 8.

(17) ಃΒ࿯ ᑗֿੰ‫ޑ‬໯१ࡌ᝼ 2001 ԃ‫޹ܭ‬ើ‫่݀زࣴޑ‬ᡉҢǴ྽ჴᡍಔ‫ڙ‬၂‫ޣ‬ၲ‫ډ‬ᡏख़Πफ़ǵफ़ եિެឪ‫ڗ‬ǵफ़եႫ‫ک‬િެឪ‫ڗ‬ǵቚуᑧ१ᠼᆢឪ‫ڗ‬Ϸၮ୏ύ‫ޑ‬΋໨‫܈‬ ӭ໨ਔǴᑡ஻ᑗֿੰ‫ޑ‬ᐒ౗Кჹྣಔ࣬ჹ෧Ͽ 58%(Tuomilehto , 2001)Ƕ ӧ Diabetes prevention Program ࿶ၸ 2.8 ԃ‫ޑ‬ଓᙫࣴ‫ز‬Ǵ่݀ᡉҢуம໯ १Ϸၮ୏‫ޑ‬ғࢲࠠᄊᑡ஻ᑗֿੰ‫ޑ‬ᐒ౗ၨჹྣಔ࣬ჹ෧ϿΑ 58%(Knowler et al., 2002)Ǵ໯१௓‫ڋ‬ёᇥࢂᑗֿੰ᏾ᡏ‫ݯ‬ᕍ‫୷ޑ‬ᘵǶӧ 1940 Կ 1970 ԃ໔ऍ୯ᑗֿੰᏢ཮ගрΑज़‫ڋ‬ឪ‫ڗ‬ଯᅹНϯӝ‫ࡌޑނ‬᝼Ƕ ᒿ๱ᅹНϯӝ‫ނ‬ᆶဟ๻ᑗऐ‫ڙ‬௃‫׎‬Ϸી৞ન‫࣬ޑ‬ᜢࣴ‫่݀ز‬р౜Ǵӧ 1986 ԃࡕωΞගଯΑᅹНϯӝ‫ޑނ‬ឪ‫ڗ‬ໆǶԖࣴ‫ز‬ϩ‫݋‬ಃ 2 ࠠᑗֿੰ஻ ‫ޑޣ‬໯१ಞᄍǴว౜όӞԐᓓ‫܈‬ᗺЈϸԶ཮٬Ոᑗ௓‫ڋ‬ό٫(Schmidt et al., 1994)Ƕ ᑗֿੰᔼᎦᙴᕍ‫ޑ‬Ҟ኱ࣁၲ‫ډ‬٠ᆢ࡭౛གྷ‫ޑ‬жᖴ௓‫ڋ‬Ǵ٬ՈᑗǵՈ િǵՈᓸ௓‫ڋ‬ӧ҅தጄൎǶႣٛᆶ‫ݯ‬ᕍᑗֿੰᄌ‫ٳ܄‬วੱǶ፾྽‫ޑ‬অ҅ᔼ Ꭶឪ‫ڗ‬ᆶғࢲࠠᄊǴаႣٛᆶ‫ݯ‬ᕍ‫ޥ‬औǵՈિ౦தǵЈՈᆅ੯ੰǵଯՈ ᓸᆶ๝ੰᡂǶᅈ‫ঁى‬ձሡ‫؃‬Ǵ࿶җ଼ந१‫ޑނ‬ᒧ᏷Ǵග‫ٮ‬ᔼᎦ֡ᑽ‫ޑ‬໯१ (Connor et al., 2003)Ƕ ਥᏵ 2000 ԃऍ୯ᑗֿੰᏢ཮ჹಃ 2 ࠠᑗֿੰ‫ޑ‬໯१ࡌ᝼ࣁ: 1. ೈқ፦эᕴ዗ໆ‫ ޑ‬10-20%ǴԖᑗֿੰ๝ੰᡂ‫ޣ‬ᔈज़‫ڋ‬ӧ 0.8 լ/ϦАǴ ऩૈज़‫ڋ‬ӧ 0.6 լ/ϦА‫׳‬ӳǶ. 9.

(18) 2. િެᔈϿ‫ܭ‬ᕴ዗ໆ‫ ޑ‬30% ǴႫ‫ک‬િެᔈϿ‫ܭ‬ᕴ዗ໆ‫ ޑ‬10% Ǵ‫ځ‬ύൂ ϡόႫ‫ک‬િެᔈэᕴ዗ໆ‫ ޑ‬10-15%Ǵᖌ‫ڰ‬ᎇ‫؂‬ϺᔈϿ‫ ܭ‬300 డլǶ 3. ᅹНϯӝ‫ނ‬эᕴ዗ໆ‫ ޑ‬50-60% Ǵа൤֖ᠼᆢ፦‫ޑ‬ᅹНϯӝ‫ڗނ‬жᆒ ጏ‫ޑ‬१‫ނ‬Ǵᅰໆаፄӝ‫ޑ‬ӭᗐᜪ‫ڗ‬жൂᗐ१‫ނ‬Ƕ 4. ឪ‫ޑ୼ىڗ‬ᠼᆢ፦Ǵࡌ᝼ໆࣁ 20-35 լ/ϺǶ 5. १ᡶࡌ᝼Ϯຬၸ 2400-3000 డլ/ϺǴऩԖଯՈᓸᔈϿ‫ ܭ‬2400 డլ/ϺǴ ऩԖᑗֿੰ๝ੰᡂ߾ࡌ᝼Ͽ‫ ܭ‬2000 డլ/ϺǶ 6. ֡ᑽ‫ޑ‬ᑗֿੰ໯१ᔈӃीᆉ஻‫ޑޣ‬౛གྷᡏख़ǴӆਥᏵੰ஻‫୏ࢲޑ‬ໆග ‫ٮ‬፾྽‫ޑ‬዗ໆǴฅࡕӆीᆉ‫ځ‬ΟεᔼᎦન‫܌‬э‫ޑ‬዗ໆК‫ ٯ‬Ƕ 1981 ԃ Jenkins ฻ΓගрΑܹᑗࡰኧࡕЇଆΑεৎ‫ݙޑ‬ཀǶ ܹᑗ ࡰኧࢂа֖Ԗ 50 լဟ๻ᑗࣁୖԵ१‫ނ‬Ǵஒ֖ 50 լᅹНϯӝ‫֖ޑނ‬ᑗ१ ‫ނ‬Кၨ‫ځ‬Ոᑗϸᔈ‫܌‬ள(Jenkins et al., 1981)Ƕ೯தаဟ๻ᑗ‫܈‬қរхբࣁ ୖԵ१‫֖کނ‬฻ໆᅹНϯӝ‫ࡑނ‬ෳ१‫ނ‬ǴКၨ࣬ӕਔ໔ΠՈዀύဟ๻ᑗ ᐚࡋ‫ޑ‬ԔጕΠय़ᑈ(area under the curve; AUC) Ǵа኱ྗ१‫ޑނ‬ϸᔈԔጕ Πय़ᑈࣁ 100Ǵ٩‫ׇ‬Кၨள‫࣬ډ‬ჹॶǶܹᑗࡰኧ‫ޑ‬ीᆉБԄӵΠ. ܹᑗࡰኧ=. ֖Ԗ 50 ϦլᅹНϯӝ‫ڙޑނ‬ෳ१‫ނ‬Ոᑗय़ᑈ ֖Ԗ 50 ϦլᅹНϯӝ‫ୖޑނ‬Ե१‫ނ‬Ոᑗय़ᑈ. x100. ൤֖ᑧ१ᠼᆢ፦‫ޑ‬१‫ނ‬εӭࣁեܹᑗࡰኧ‫ޑ‬१‫ނ‬Ƕ2001 ԃ΋໨ଞჹ ኻࢪ 2810 Տಃ 1 ࠠᑗֿੰ஻‫ޑ଺܌‬ଓᙫࣴ‫ز‬ว౜Ǵឪ‫ڗ‬եܹᑗࡰኧ‫ޑ‬१. 10.

(19) ‫ނ‬ᆶᑗϯՈՅનफ़եԖᜢ(Buyken et al., 2001)Ƕ2004 ԃ Hodge ฻Ꮲ‫ޣ‬аᐞ ࢪ 36787 Տ଼ந҇౲ࣁჹຝǴ࿶ၸ 4 ԃ‫ޑ‬ଓᙫว౜Ǵឪ‫ڗ‬ଯᅹНϯӝ‫ނ‬ ՠեܹᑗࡰኧ‫ޑ‬१‫ނ‬ёफ़եᑡ஻ᑗֿੰ‫ޑ‬Ӓᓀ‫(܄‬Hodge et al., 2004)Ƕӕ ԃ Schulze ฻Ꮲ‫ޣ‬ଞჹऍ୯ 91249 Տζ‫ ޑ଺܌܄‬8 ԃଓᙫࣴ‫ز‬ว౜Ǵܹᑗ ࡰኧᆶᑗֿੰ‫ޑ‬Ӓᓀ‫܄‬ԋ҅࣬ᜢ(Schulze et al., 2004) ǶќѦΨԖ೚ӭࣴ‫ز‬ ว౜Ǵեܹᑗࡰኧ‫ޑ‬१‫ނ‬ёаफ़եᖌ‫ڰ‬ᎇǵեஏࡋિೈқᖌ‫ڰ‬ᎇ‫ޑ‬ᐚࡋ ຾Զफ़եЈՈᆅ੯ੰ‫ޑ‬Ӓᓀ‫(܄‬Liu et al., 2000; Frost et al., 1999; Turley et al., 1998)Ƕ. 11.

(20) ಃΟ࿯ ᑧ१ᠼᆢ፦ᆶᑗֿੰ ᠼᆢ፦Ѭࢂӭঁဟ๻ᑗϩηаE-1,4 ᗖ่่ӝԶԋǴΓᡏϣӢલЮϪ ᘐ೭ᅿᗖ่БԄ‫੃ޑ‬ϯሇનǴ‫܌‬аค‫ݤ‬ϩှճҔǶ1973 ԃԖᏢ‫ޣ‬ගрᑧ १ᠼᆢ‫ۓޑ‬ကǴค‫ݤ‬೏Γᡏဉၰሇન‫܌‬ϩှ‫ޑ‬෌‫ނ‬ಒझᏛхࡴᠼᆢન ȐcelluloseȑǵᆫѹᗐȐpentosanȑǵЕ፦નȐligninȑǵᑗ⾺ለȐglucuronic acidȑȐTrowell,1994ȑǶ1994 ԃ‫ځ‬дᏢ‫߾ޣ‬ᇡࣁᑧ१ᠼᆢᔈх֖ᜤ੃ϯ ᐘણǵЕ፦નǵߚᐘણӭᗐᜪϷᜤ੃ϯჲᑗȐLee and Porsky, 1994ȑǶ ! ! ᑧ१ᠼᆢ፦‫ڀ‬Ԗౢғᗹ‫܄‬ϷᏉጤ‫܄‬ǵ֎ߕԖᐒ‫ނ‬፦ǵౢғอ᜘િެ ለ‫ߥک‬НΚ‫ނޑ‬౛фૈǴϩձඔॊӵΠǺ 1.ౢғᗹ‫܄‬ϷᏉጤ‫܄‬ ᑧ१ᠼᆢ፦೏༾ғ‫ނ‬ϩှࡕ཮ౢғ஥Ԗཱུ‫ޑ܄‬ӭᗐᡏǴ‫ڀ‬ᒃН‫܄‬ ёᆶεໆН่ӝ‫׎‬ԋᏉጤǶԖࣴ‫ز‬ว౜ᑧ१ᠼᆢ፦ёቚуဉၰϣ৒‫ނ‬ℚ ࡋǴ‫ڋ׭‬ᔼᎦન֎ԏǴቚуλဉϣ৒‫ނ‬ȐBegin et al., 1989ȑǶ 2. ֎ߕԖᐒ‫ނ‬፦ ᑧ१ᠼᆢ፦‫ڀ‬Ԗ֎ߕԖᐒ‫ނ‬፦ӵᖌለǵᖌ‫ڰ‬ᎇǵԖࢥ‫ނ‬፦฻‫ޑ‬բ ҔǶࣴ‫ࡰز‬рᑧ१ᠼᆢ፦཮ߦ຾௨‫ݧ‬ᕨߡύᖌለǴ෧Ͽဉ‫ط‬ൻᕉύᖌለ ϐӣԏǴߦ຾ӝԋ‫ޑ‬ᖌለໆǴ෧ϿՈనύᖌ‫ڰ‬ᎇᐚࡋȐGarcia-Diez et al., 1996ȑǶ 3. ౢғอ᜘િެለ. 12.

(21) ӭᗐᜪ೏ဉၰ༾ғ‫ނ‬ϩှࡕౢғอ᜘િެለǴอ᜘િެለ೏֎ԏ٠ ග‫ૈٮ‬ໆЪफ़եεဉ pH ॶǴቹៜ༾ғ‫ޑނ‬ሇનࢲ‫܄‬Ǵቚу༾ғ‫ނ‬Ϸᕨߡ ᡏᑈȐRoss and Leklem, 1981ȑǶ 4.ߥНΚ ᑧ१ᠼᆢ፦٩‫ځ‬Нྋ‫܄‬Ǵ߾ϩࣁНྋ‫܄‬ᑧ१ᠼᆢ፦‫ߚک‬Нྋ‫܄‬ᑧ१ ᠼᆢ፦ǶНྋ‫܄‬ᑧ१ᠼᆢ፦хࡴъᠼᆢ፦ȐhemicelluloseȑǵᐋጤȐgumȑǵ ݀ጤȐpetinȑǵᗹጤȐmucilagesȑǶߚНྋ‫܄‬ᑧ१ᠼᆢ፦хࡴᠼᆢનǵ Е፦નϷԖ٤ъᠼᆢ፦(ӵ: Е⾺ᑗ xyloseǵҒ៛ᑗ mannose )ǶНྋ‫܄‬ᑧ १ᠼᆢ፦ё‫ۯ‬጗ग௨‫ޜ‬ǴቚуႫ१ག෧Ͽ१‫ނ‬ϐឪ‫ڗ‬Ǵ጗‫ک‬Ոనൻᕉ֎ ԏဟ๻ᑗ‫ޑ‬ϸᔈӢԶफ़եી৞ન‫ޑ‬ϩ‫ݜ‬ǶߚНྋ‫܄‬ᑧ१ᠼᆢ፦߾ёቚу ᕨߡᡏᑈǴᕭอᕨߡ೯ၸဉၰਔ໔ǴႣٛߡ઎‫ޑ‬วғǴีញ෧ϿΒભᖌ ለफ़եεဉᕎวғ‫ޑ‬ᐒ౗Ƕ ਥᏵࢬՉੰᏢ‫زࣴޑ‬ว౜ᆒᇙ‫⟻ޑ‬ᜪϷલЮᑧ१ᠼᆢ፦‫ޑ‬໯१཮ቚ уᑡ஻εဉᕎǵ߷‫ે୏ރ‬Ј᠌ੰ‫ޑ‬ӒᓀȐTrowell , 1972; Burkitt et al., 1971ȑǶᝩ Burkitt ฻Ꮲ‫زࣴޣ‬ϐࡕǴ‫ځ‬дࣴ‫ز‬Ψӕኬว౜ᑧ१ᠼᆢ፦ё ෧Ͽᄌ‫ੰ܄‬วғ‫ޑ‬ӒᓀȐKushi et al., 1999ȑǶӄ⟻ᜪ‫ޑ‬ឪ‫ڗ‬ᆶಃ 2 ࠠᑗ ֿੰ‫ޑ‬Ӓᓀ‫܄‬ԋॄ࣬ᜢȐMontonen et al., 2003ȑǶ ! ! ᖏ‫زࣴ׉‬ว౜Нྋ‫܄‬ᑧ१ᠼᆢ፦‫ڀ‬Ԗ‫ۯ‬጗ᑗֿੰ஻໭ࡕՈᑗ‫ک‬ી৞ નᐚࡋ‫ޑ‬΢ϲǴӕਔჹ‫ׯ‬๓Ոિ፦‫ޑ‬౦தΨԖᔅշȐSimpson et al.,. 13.

(22) 1981ȑǶ2001 ԃԖࣴ‫ࡰز‬рಃ 2 ࠠᑗֿੰ஻‫ޣ‬ឪ‫ڗ‬൤֖ᠼᆢ፦‫ޑ‬१‫ځ(ނ‬ ύ֖ 50%‫ޑ‬Нྋ‫܄‬ᠼᆢ) Ǵ6 ຼࡕᡉ๱‫ׯ‬๓ΑՈᑗ‫ک‬Ոિ፦ȐMcIntosh and Miller, 2001ȑǶќѦԖࣴ‫ز‬ว౜Нྋ‫܄‬ᑧ१ᠼᆢ፦E-glucan ‫ډ‬ၲλဉਔ཮ ቚу१‫ޑނ‬ᗹ࿨‫܄‬Ǵё‫ۯ‬጗֎ԏǴऩዼ‫ނ‬ύ֖ 10 ʝE-glucanǴё٬Ոᑗ ଯঢ়Πफ़ 50 ʝȐWursch et al., 1997ȑǶ ᐪഝΨࢂΓᜪЬा१Ҕϐዼᜪϐ΋ǴѬ֖Ԗᙦ൤‫ޑ‬ೈқ፦ǵિެǵ ້ǵᕗǵ៓Ϸᆢғન B ဂǶ‫ځ‬િެ‫֖ޑ‬ໆࣁഝᜪύനӭ‫ޣ‬Ƕᗐᜪ‫ޑ‬Ьा ԋҽࣁᐘણǴೈқ፦аዼೈқࣁЬǶ‫ޑ֖܌‬ᆢғન B1ǵB2Ǵ๨ᡵનၨқ ԯϐ֖ໆଯǶ٠Ъ֖Ԗᙦ൤‫ޑ‬Нྋ‫܄‬ᠼᆢ፦Ϸ ȕ-ᆫဟ๻ᑗȐȕ-glucanȑǶ Tappy ฻ࣴ‫ࡰز‬рǴ๏ϒಃ 2 ࠠᑗֿੰ஻ 35 լᗐᜪǴ‫ځ‬ύ֖Ԗ 5 լࢂ ȕᆫဟ๻ᑗǴᑗֿੰ஻‫ܹޑ‬ᑗϸᔈёफ़ե 50%ϐ౜ຝ(Tappy et al., 1996)Ƕ ൤֖ ȕ-ᆫဟ๻ᑗ‫ޑ‬໯१ჹಃ 2 ࠠᑗֿੰ஻‫ޑޣ‬໭ࡕՈᑗԖፓ࿯‫ޑ‬բҔ (Braaten et al., 1994)Ƕӧᖏ‫زࣴ׉‬ว౜Ǵಃ 2 ࠠᑗֿੰ஻१Ҕ൤֖ଯᠼᆢ ፦‫ޑ‬ᐪഝౢࠔ 12 ຼࡕǴᡉ๱‫ׯ‬๓ՈᑗǵՈዀી৞નϷՈિϸᔈ (Pick et al., 1996)Ƕӧऐ‫ڙ‬၂ᡍύǴಃ 2 ࠠᑗֿੰ஻ឪ‫ڗ‬൤֖ ȕ-ᆫဟ๻ᑗ‫ޑ‬ᐪഝᎽរ ણǴ‫ڀځ‬Ԗၨե‫ܹޑ‬ᑗϸᔈȐglycemic responseȑǴёफ़եՈᑗϸᔈᆶᓓ ࡕ‫ޑ‬Ոᑗॶ(Tapola et al., 2005)Ƕ൤֖ ȕ-glucan ‫ޑ‬εഝរણᇙࠔჹՈᑗж ᖴԖࡐӳ‫ޑ‬ϸᔈ੝ձࢂી৞ન‫ޑ‬ϸᔈ)Casiraghi et al., 2006*Ƕ! ЈՈᆅ੯ੰࢂᑗֿੰനத‫ޑـ‬εՈᆅ੯ੰǴΨࢂᑗֿੰ஻ԝΫ‫ޑ‬Ь. 14.

(23) ाচӢǶᑗֿੰ஻৒ܰᑡ஻ЈՈᆅ੯ੰ‫ޑ‬চӢࡐӭǴନΑᑗֿੰҁ‫ي‬஥ ٰϐଯՈᑗϷી৞નߔ‫܄ל‬ѦǴՔᒿᑗֿੰԶٰ‫ޑ‬ଯՈિǵଯՈᓸǵ‫ޥ‬ औ฻Ψ‫ת‬ᄽख़ा‫ف‬ՅǶ‫ځ‬ύаՈિ౦த‫ޑ‬ख़ा‫ࢂ׳܄‬ό৒۹ຎǶ‫܌‬аᝄ ਱‫ޑ‬௓‫ڋ‬Ոᑗࢂᑗֿੰ஻‫ޣ‬Ⴃٛ‫ٳ‬วЈՈᆅ੯ੰሡոΚ‫ޑ‬ፐᚒǶࣴ‫ز‬ว ౜͊-ᆫဟ๻ᑗᆶЈ᠌ՈᆅБय़‫଼ޑ‬நԖஏϪᜢೱǴᐪഝύ‫͊ޑ‬-ᆫဟ๻ᑗ ૈफ़եՈύᕴᖌ‫ڰ‬ᎇᆶեஏࡋિೈқᖌ‫ڰ‬ᎇǴ຾Զफ़ե߷‫ે୏ރ‬੯ੰ‫ޑ‬ Ӓᓀ‫(܄‬Jenkins et al., 2003)Ƕ. 15.

(24) ಃѤ࿯ ሐᆶᑗֿੰ ሐ(Chromium )ࢂΓᡏѸሡ‫ޑ‬༾ໆϡનǴѬԖΟሽ Cr(III)ᆶϤሽ Cr(VI) ϐϩձǴаΟሽሐനᛙ‫ۓ‬Ǵӧ१‫ނ‬ύሐӭаΟሽ‫ࠠޑ‬ԄӸӧǶሐ‫ޑ‬१‫ނ‬ ٰྍࣁԺᜪϷӄዼᜪǶ֖ໆᙦ൤‫ޣ‬ᗋԖଆљǵ⏯ᜪǵ޸ғǵᝳแǵ୥ଚǶ ሐ‫֎ޑ‬ԏѸ໪࿶ၸλဉǴЀ‫ޜࢂځ‬ဉǶЬाࢂ٩ᒘឫ஥‫ (ޣ‬carrier )аᘉණ БԄ֎ԏǶ֎ԏ౗εऊ 0.4-2.5%Ǵεӭኧ‫ޑ‬ሐ҂೏֎ԏԶᒿᕨߡ௨ନǴ ֎ԏ‫ޑ‬ሐΨ཮‫ז‬ೲҗֿన௨рᡏѦǶ ሐ‫ޑ‬Ьा‫ޑ‬фૈᆶᗐᜪ‫ک‬િ፦жᖴԖᜢǴࢂȨဟ๻ᑗऐ‫ڙ‬Ӣηȩ ȰGTFǴglucose tolerance factorȱ‫ޑ‬ಔԋϩϐ΋Ǵ‫ࣁځ‬ሐᆶ๨ᡵન‫ک‬ữ୷ ለ‫ޑ‬ϯӝ‫ނ‬Ƕӧന߈‫ࡰزࣴނ୏ޑ‬рǴሐ‫ޑ‬ϟΕё෧ϿᑗֿੰႵϐଯՈ ᑗੱ‫(ރ‬Han et al., 2003)Ǵ٠‫ׯ‬๓ಃ 2 ࠠᑗֿੰλႵ๝᠌‫ޑ‬ሐᐚࡋа‫ׯ‬๓ ๝фૈ(Mita et al., 2005)ǶԖᐒሐࢂΓᡏന৒ܰ֎ԏϷനӼӄ‫ޑ‬ሐ‫׎‬ᄊǴ Ԗᐒሐૈຠߕӧી৞ન΢Ǵ٬ಒझ΢‫ޑ‬ી৞ન‫ڙ‬Ꮤ ( receptor )Ǵ ૈкϩ ֎ԏી৞નǴமϯಒझჹી৞નϐ่ӝфૈǶી৞નёߦ຾ԼԺಔᙃύ ‫ޑ‬ӝԋբҔ( anabolic reaction )ǴԶЪ‫ڋ׭‬౦ϯբҔ( catabolic reaction )Ǵ уೲೈқ፦‫ޑ‬ӝԋǹΞૈफ़եՈనύᖌ‫ڰ‬ᎇ‫ک‬ΟለҒ‫✊ݨ‬Ǵ‫ڐ‬շિެж ᖴ‫ک‬ቚуዧԼԺಔᙃǶ1993 ԃ Anderson ‫ޑ‬ൔ֋ࡰрӧऍ୯εӭኧΓ(Ѐ ‫ࢂځ‬ԴԃΓ)ೀ‫ܭ‬ሐឪ‫ڗ‬ໆલЮ‫ރޑ‬ᄊǴಔᙃύ‫ޑ‬ሐ֖ໆᒿ๱ԃសቚуԶ फ़եǴဟ๻ᑗ‫ޑ‬ऐ‫܄ڙ‬ᒿ๱ԃសቚуԶफ़եǴӢԜሐ೏ᇡࣁࢂ΋ᅿख़ा. 16.

(25) ‫ޑ‬ᔼᎦનǴԶӧऍ୯നදၹ‫ံޑ‬кᏊಃΒՏ൩ࢂሐ‫ံޑ‬кᏊȐHellerstein , 1998ȑǶሐલЮ཮೷ԋી৞ન‫܄ל‬ቚуЇଆଯી৞નՈੱȐZavaron et al., 1989ȑ ǶMertz ࡰрሐёፓ࿯ી৞નфૈᆢ࡭Ոᑗ‫ۓࡡޑ‬ȐMertze , 1969ȑǶ ࣴ‫ࡰز‬рಃ 2 ࠠᑗֿੰ஻‫ޣ‬Ոమύሐ‫֖ޑ‬ໆၨߚᑗֿੰ஻‫ޣ‬եȐMorris et al., 1988ȑǶ߈ԃٰҗ Anderson ฻Γ‫ࡰزࣴޑ‬рឪ‫ڗ‬ሐё‫ׯ‬๓ဟ๻ᑗऐ‫ڙ‬ ‫܄‬ȐAnderson et al., 1990ȑ; 1997 ԃ Davis ฻Γ‫ࡰ׳‬рឪ‫ڗ‬ሐё‫ׯ‬๓ಃ 2 ࠠᑗֿੰ஻ဟ๻ᑗऐ‫܄ڙ‬ȐDavis et al., 1997ȑǶ Կ‫ܭ‬၀ឪ‫ڗ‬ӭϿໆω‫୼ى‬Ǵӧ 1989 ԃ RDA ਥᏵऍ୯ε೽ϩΓ‫؂‬Ϻ ѝाឪ‫ ڗ‬50 μg ‫ঁޑ‬൩ёႣٛሐલЮ‫ޑ‬วғǴԶගрჹߙϿԃϷԋΓሐ‫ޑ‬ ࡌ᝼ໆࣁ 50~200 μgǶ‫ך‬୯‫ޑ‬୯ΓᔼᎦનឪ‫ୖڗ‬Եໆ(Dietary Reference Intakes, DRIs)Ҟ߻٠ؒԖሐ‫ޑ‬ឪ‫ࡌڗ‬᝼ໆǶ Rabinowitz ฻Ꮲ‫زࣴޑޣ‬ύǴ๏ಃ 2 ࠠᑗֿੰੰ஻٬Ҕ 150 μg ‫ޑ‬ෛ ϯሐံкᏊǴว౜ჹՈᑗ٠คቹៜ(Rabinowitz et al., 1983)ǶԶ Mossop ฻ Ꮲ‫ࢂ߾ޣ‬٬Ҕ 600 μg ‫ޑ‬ෛϯሐံк 3 ঁДࡕ໭߻ՈᑗܴᡉΠफ़(Mossop , 1983)Ƕ΋ঁӧ 2004 ԃᖏ‫زࣴ׉‬ว౜Ǵ‫ܭ‬໯१ύబу 50 μg ሐჹ‫ܭ‬ಃ 2 ࠠ ᑗֿੰ஻Զ‫ق‬Ǵჹ‫ׯ‬๓஻‫ޣ‬໭߻‫ک‬໭ࡕՈᑗᐚࡋǵՈనύᖌ‫ڰ‬ᎇϷΟለ Ғ‫ޑ✊ݨ‬ᐚࡋКଆ໺಍‫ޑ‬ե዗ໆ໯१‫׳‬Ԗਏ(Sharafetdinov et al., 2004)Ƕ. 17.

(26) ಃΟക ‫׷‬਑ᆶБ‫ݤ‬ ಃ΋࿯ ‫ڙ‬၂‫ޣ‬ җ଄ი‫ݤ‬ΓϺЬ௲ဃߥ࿢অζ཮ᙴଣཥഋжᖴࣽߐບ‫ܕ‬༅ԃស 35-70 ྃಃ 2 ࠠᑗֿੰੰ஻Ӆ 14 ӜǴ‫ځ‬ύ‫ ܄ت‬7 ӜǴζ‫ ܄‬7 Ӝୖᆶҁࣴ ‫ز‬Ƕჴᡍය໔‫҇ܭ‬୯ 95 ԃ 2 Д 15 ВԿ҇୯ 95 ԃ 5 Д 22 ВǶҁࣴ‫ޑز‬ ჴᡍಒ߾࿶ၸᆵчᙴᏢεᏢᏢೌࣴ‫ہز‬঩཮Γᡏ၂ᡍቩࢗλಔቩਡ೯ ၸǶᑔᒧచҹӵΠǺ࿶ཥഋжᖴࣽᙴৣບᘐࣁಃ 2 ࠠᑗֿੰ‫ޣ‬Ǵ௨ନӝ ‫ٳ‬Ԗ๝᠌ੰǵဉगၰ੯ੰǵ‫᠌ط‬੯ੰǵઓ࿶‫܄‬੯ੰǵൾ‫܄‬ဍዦǵᚶѫǵ থ٢஁ζ฻Ƕ಄ӝа΢ࣴ‫ز‬చҹ٠ᜫཀୖᆶ‫ޣ‬Ǵᒧ‫ࣁۓ‬ҁࣴ‫ز‬ϐ‫ڙ‬၂‫ޣ‬ ٠༤ቪӕཀਜǶࣴ‫ز‬ය໔ᆢ࡭ςԖ‫ޑ‬ᛰ‫ނ‬٬ҔǴ໯१ीฝଛӝჴᡍ‫܌‬೛ ीǴၮ୏ᆢ࡭ѳத‫ޑ‬ಞᄍǶ. 18.

(27) ಃΒ࿯ ჴᡍࢬำ‫ک‬೛ी ΋ǵჴᡍࢬำკ! ᑔᒧ‫ڙ‬၂‫!ޣ‬. ! !. ᡏՏෳໆ! ໯१ຑ՗! ғϯᔠࢗ!. ჴᡍಔ!. ჹྣಔ!. уሐᐪഝϟΕ!. ଳᔿқԯТ! 5 ຼ!. ᡏՏෳໆ! ໯१ຑ՗! ғϯᔠࢗ! 5 ຼ!. ᡏՏෳໆ! ໯१ຑ՗! ғϯᔠࢗ!. ԏ໣ኧᏵǵ಍ीϩ‫݋‬໯१ϟΕ߻ࡕϐৡ౦! 19. !.

(28) Βǵჴᡍ೛ी ҁࣴ‫ࣁࣁز‬ය 8 ຼ‫ޑ‬໯१ϟΕࣴ‫ز‬ǶӃஒ‫ڙ‬၂‫ޣ‬ϩࣁჴᡍಔϷჹྣ ಔǴ‫ڙ‬၂‫ޣ‬ӧۘ҂຾Εჴᡍ߻Ϸ຾ΕჴᡍࡕಃѤǵΖຼǴҗᔼᎦৣа΋ ჹ΋‫ޑ‬၌ୢБԄǴа 24 λਔӣᏫ‫ڗݤ‬ள‫ڙ‬၂‫ޣ‬ϐ໯१इᒵǶჴᡍ໒‫ࡕۈ‬ ๏ϒჴᡍಔ‫ڙ‬၂‫؂ޣ‬В΋хуሐᐪഝǴჹྣಔ‫ڙ‬၂‫؂ޣ‬В΋хଳᔿқԯ ТǶуሐᐪഝ‫ک‬ଳᔿқԯТ೿ࢂҗ٫਱१ࠔިҽԖज़Ϧљ‫܌‬ග‫ٮ‬Ƕ٩ྣ ౢࠔ٬ҔᇥܴǴబу‫ڙܭ‬၂‫ޣ‬ϐ໯१ύǴਥᏵঁձϐ໯१ಞᄍ๏ϒံкǴ ёబу‫ܭ‬ᗺЈ‫҅܈‬ᓓϐύǶ१ҔБ‫ࣁݤ‬ஒуሐᐪഝ‫܈‬ଳᔿқԯТу 350cc ዗Нؑ‫ݰ‬ᓉ࿼ 3-5 ϩដջё१ҔǶ‫ڙ‬၂‫ޣ‬ӧჴᡍ໒‫ۈ‬ಃ 0 ຼǵಃ 4 ຼǵಃ 8 ຼǴ‫ڗܜ‬Ոనኬҁ຾ՉՈనϩ‫݋‬Ƕ. 20.

(29) ಃΟ࿯ ၗ਑ԏ໣‫ک‬ϩ‫݋‬Б‫ݤ‬ ΋ǵᡏՏෳໆ ‫ܭ‬ჴᡍ໒‫߻ۈ‬Ǵෳໆ‫ڙ‬၂‫يޣ‬ଯǵᡏख़ᆶᡏિެǴჴᡍ໒‫ࡕۈ‬ಃѤǵ ΖຼǴෳໆ‫ڙ‬၂‫ޣ‬ᡏख़ᆶᡏિެǴ٠ीᆉ‫ي‬ᡏ፦ໆࡰኧ(body mass indexǹ BMI) Ǵ‫ي‬ଯᡏख़ी฻ሺᏔ࿶ၸਠ҅Ǵҗ‫ڙ‬ၸ૽ግ‫ޑ‬Γ঩຾Չෳໆ‫ي‬ଯᡏ ख़Ƕෳໆ໨ҞϷБ‫ݤ‬ӵΠ 2/. ‫ي‬ଯǺ‫ڙ‬၂‫ޣ‬ಥᎠǵಥ൰ǵ‫ܩ‬ᓐਇૅǵᚈဌ‫ٳ‬ᚺǵᚈЋԾฅΠ ࠟǵ‫ٿ‬౳ѳຎ҅߻БǴ౳࿊҃ఋᆶԸԚύᗺϐೱጕሡᆶᕅय़ࠟ ‫ޔ‬Ǵࡕဌၟᆶުछମԋ‫ޔ‬ጕ٠ᆶෳໆఎѳՉǴፓ᏾όឌᒳచ‫ޔ‬ ԿᓐഗǴᓸѳ‫ڙ‬၂‫ޣ‬ϐᓐഗࡕ᠐‫يڗ‬ଯॶǴаϦϩࣁൂՏǴᆒ ዴࡋԿλኧᗺаΠಃ΋ՏǶ. 3/. ᡏख़Ǻᡏख़ीᆶ‫؂‬ԛෳໆ߻Ӄᘜ႟Ǵ‫ڙ‬၂‫ޣ‬ஒᎠηᆶ‫ي‬΢ࠆख़ Պ‫ނ‬ಥѐǴઠҥ‫ܭ‬ѳѠύѧဌඓѳՉ௦Ծฅઠ࠮Ǵ᠐‫ڗ‬ᡏख़ॶǶ. 4/. ᡏિެǺ௦Ҕ‫ىډى‬ғ‫ނ‬ႝߔϩ‫݋‬ሺ(Tanita;TBF-531A)ෳໆǶ. 5/. ‫ي‬ᡏ፦ໆࡰኧǺ ‫ي‬ᡏ፦ໆࡰኧɨ ᡏख़(ϦА)/Ș‫ي‬ଯ(ϦЁ)ș2. 21.

(30) ΒǵՈనኬҁԏ໣Ϸϩ‫݋‬ ‫؂‬ԛ‫ܜ‬ՈਔǴ‫ڙ‬၂‫ޣ‬೏ा‫ܜܭ؃‬Ո߻΋Ϻఁ΢ 10 ᗺаࡕ࿣१Ƕ٠‫ܭ‬ ‫ܜ‬Ո྽Вԏ໣‫ڙ‬၂‫ޜޣ‬ဎϷ໭ࡕ 2 λਔϐՈన຾Չϩ‫݋‬ǶՈనϩ‫ࢂ݋‬а ଄ი‫ݤ‬ΓϺЬ௲ဃߥ࿢অζ཮ᙴଣᔠᡍࣽ‫ޑ‬ᑗϯՈՅનϩ‫݋‬ሺ TOSOH G7 ຾ՉᑗϯՈՅન‫ޑ‬ϩ‫݋‬Ǵ‫ځ‬д໨Ҟ߾ࢂҔ Toshiba C8000 ՈనԾ୏ϩ ‫݋‬ሺ຾Չϩ‫݋‬Ƕԏ໣Ոనᔠᡏࡕϩձ࿼‫ܭ‬όӕᚆЈᆅ(ऍ୯ѸࡆϦљғ ౢ)ǴᑗϯՈՅન٬Ҕ֖ EDTA ϐᚆЈᆅǴՈᑗ٬Ҕ֖ NaF ϐᚆЈᆅǴ‫ځ‬ д໨Ҟ٬ҔՈమϩ‫݋‬ᆅǶନᑗϯՈՅન٬ҔӄՈѦǴ‫ځ‬Ꭹᔠᡏ‫ڙܭ‬ᔠࡕ а 300 rpm ᚆЈ 10 ϩដ‫ڗ‬Ոዀ‫ک‬Ոమ຾Չϩ‫݋‬ǶӚ໨ϩ‫݋‬চ౛ӵΠ:! 1.ဟ๻ᑗȐglucoseȑǺ ճҔ HK.G-6-PD.NADP ‫ݤ‬Ƕ ϸᔈচ౛Ǻ! Hexokinase Glucose + ATP. Glucose-6-phosphate + ADP. Glucose-6-phosphate Dehydrogenase 6-phosphogluconic acid + Glucose-6-phosphate + NADP+ NADPH !!΢ॊϸᔈӧ 451!on ‫ߏݢ‬КՅෳр!OBEQI!‫֎ޑ‬ӀࡋቚуໆǴ!ջёளဟ ๻ᑗᐚࡋ ! 2.ી৞ન(Insulin) Ոమી৞નᐚࡋ٬Ҕ‫ܫ‬৔խࣝ၂ᡍ঺ಔ (radioimmunoassay kit) 22.

(31) ϩ‫݋‬Ƕ 3.ᑗϯՈआન(Glycosylated Hemoglobin,HbA1C) ճ Ҕ ໚ ᚆ η Ҭ ඤ ଯ ਏ ౗ న ӛ ቫ ‫( ݤ ݋‬Cation-exchange High performance Liquid Chormatography)ǴᔠᡏаྋᚆనϷؑࢱనԾ୏‫ޑ‬уа ีញӧ຾Ε column ύǴ٩ᒘӚՈՅન N ᆄ‫܌‬஥ႝ಻όӕǴவ഍ႝ‫܄‬மԿ ১٩‫ׇ‬ϩᚆр: A1aǵA1bǵHbFǵL-A1ǵA1c Ϸ A0ǶӚᅿՈՅન‫ޑ‬ಔԋҗ column ؑрࡕ೯ၸୀෳᏔǴӧ‫ ߏݢ‬415nm Πᅱຎ֎Ӏॶ‫ׯޑ‬ᡂǶ‫؂‬΋ঁ peak ‫ޑ‬य़ᑈᕴ‫߄ک‬Ңԋ total areaǴа‫؂‬΋ঁ peak य़ᑈନа total area ‫ޑ‬К ‫߄ٯ‬ҢԋԭϩКǶ A1c(%) = A1c area/total area 4.Ոિ፦Бय़Ǻ (1)ΟለҒ‫(✊ݨ‬Triglyceride): ӧᔠᡏύΟለҒ‫཮✊ݨ‬ӧિှ䁙բҔΠНှԋҒ‫ݨ‬Ϸෞᚆ િެለǶௗ๱ճҔ glycerol kinase (GK) Ǵglycerophosphate oxidase (GPO)horseradish peroxidase ԋ 3,5-dichloro-2-hydroxylbenzee-sulfonic acid(DHBS)ᆶ 4-aminoantipyrine ਼ϯ่ӝ‫׎‬ԋ΋ᅿआՅ‫ނޑ‬፦ᔠ ᡏǶ‫ ܭ‬520nm ‫ߏݢ‬ୀෳ֎ӀॶǶ֎Ӏॶ‫ޑ‬ቚуᆶΟለҒ‫ޑ✊ݨ‬ᐚࡋ ԋ҅КǶ ϯᏢϸᔈԄ Triglyceride + H2O. ĺ glycerol + fatty acids 23.

(32) Glycerol + ATP-. ĺ glycerol-3-phosphate+ADP. Glycerol-3-phosphate + O 2 ĺ dihydroxyacetone phosphate+ H2O2 2H2O2 + 4-aminophenazone+ 4chlorophenolĺ quinoneimine+HCl+4 H2O (2) ᕴᖌ‫ڰ‬ᎇ(Total cholesterol) ճҔӆ΋‫ޑۓ‬ਔ໔ϣୀෳಖᗺϸᔈਔ֎Ӏॶ‫ׯޑ‬ᡂǴ຾Զඤᆉ рᐚࡋǶӧϸᔈύᖌ‫ڰ‬ᎇ✊䁙(cholesterol esterase)཮Нှᖌ‫ڰ‬ᎇ✊ᜪ (cholesterol ester)ԋࣁෞᚆᖌ‫ڰ‬ᎇϷિެለǶෞᚆᖌ‫ڰ‬ᎇΞ཮೏ᖌ‫ڰ‬ ᎇ਼ϯ䁙(cholesterol oxidase)਼ϯԋᖌ౎(cholest-4-3-one)Ϸၸ਼ϯ ణǶၸ਼ϯ䁙໽ϯၸ਼ϯణᆶ 4-aminoantipyrine Ϸ⇌(phenol)բҔౢ ғ‫ڀ‬ԖᚑՅ‫ ޑ‬quino-neimine ౢ‫ނ‬Ƕ‫ ܭ‬520nm ‫ߏݢ‬ୀෳ֎ӀॶǶ ϯᏢϸᔈԄ Cholesterol-ester + H2O Cholesterol + O 2. ĺCholesterol + fatty acids. ĺCholest-4-3-one + H2O2. 2H2O2+phenol +4-aminoantipyrine ĺ quinoneimine+H2O (3)եஏࡋિೈқᖌ‫ڰ‬ᎇ(Low density lipoprotein cholesterol,LDL-C)ճ ҔሇનբҔϷКՅෳ‫ۓ‬ϐচ౛ෳளǶ‫ ܭ‬520nm ‫ߏݢ‬ୀෳ֎ӀॶǶ ϯᏢϸᔈԄ LDL + H2O. ĺ Cholesterol + fatty acids. Cholesterol + O 2. ĺ Cholesterone + H2O2. 2H2O2+4-AA+HSDA+H3+O ĺ Blue purple pigment+5H2O (4)ଯஏࡋિೈқᖌ‫ڰ‬ᎇ(High density lipoprotein cholesterol ,HDL-C) 24.

(33) ᖌ‫ڰ‬ᎇ✊䁙(cholesterol esterase)ᆶᖌ‫ڰ‬ᎇ਼ϯ䁙(cholesterol oxidase)࿶ၸϯᏢঅႬࡕǴჹեஏࡋિೈқ(LDL-C) ǵཱུեஏࡋિೈ қ(VLDL-C)‫ک‬٢ᕧ༾ಈ(chylomicron)‫ޑ‬ϸᔈࢲ‫܄‬फ़եǴճҔሇનჹ LDL-C ǵVLDL-C Ϸ chylomicron ‫ޑ‬ϸᔈ‫ۯ‬ᒨǴѝԖ HDL-C ёа೏ ᒧ᏷‫ޔޑ܄‬ௗբҔǴಃ΋‫؁‬ᡯճҔᕉࠠᆫဟ๻ᑗ౷ለᡶፄӝ၂Ꮚѝ ่ӝ LDL-C ǵVLDL-C Ϸ chylomicron Զόᆶ HDL-C բҔǴಃΒ‫؁‬ ᡯ࿶ၸϯᏢঅႬࡕ‫ޑ‬ᖌ‫ڰ‬ᎇ✊䁙ᆶᖌ‫ڰ‬ᎇ਼ϯ䁙‫ޔ‬ௗբҔӧ HDL-CǶ‫ ܭ‬600nm ‫ߏݢ‬ୀෳ֎ӀॶǶ 5.ֿનේ(Blood urea nitrogen,BUN) ճҔ Urease-GLDH ‫ݤ‬Ƕаֿન⅋(Urease)ϩှֿનౢғ਽ࡕǴӧᎽữ ለѐణ䁙(glutamate dehydrogenase;GLDHα໽ϯΠǴᆶ Į-ketoglutaric acid Ϸ NADH ϸᔈౢғ glutamic acid ֗ NAD+Δ‫ א‬340nm КՅෳр NADH ෧ ϿໆǴӆ‫ ؃‬urea N ໆΖ! Urease Urea + H2O. 2NH3 + CO2. GLDH NH3 + Į-ketoglutaric acid + NADH + H. +. glutamic acid + H2O+NAD+. !΢ॊϸᔈӧ 451on ‫ߏݢ‬Πෳ‫֎ۓ‬Ӏࡋ෧Ͽໆջёள urea N ᐚࡋǶ 6.Լለὢ(Creatinine). 25.

(34) ճҔঅ҅ၸ‫ޑ‬ೲ౗ Jaffe ‫ݤ‬Ƕӧϸᔈύᔠᡏ‫ޑ‬Լለὢᆶᡵ‫܄‬ྋనϣ‫ޑ‬ ध‫ښ‬ለ(Picric acid)่࣬ӝǴ‫׎‬ԋआՅ‫ޑ‬Լለὢ-ध‫ښ‬ለፄӝ‫ނ‬Ƕ‫ ܭ‬560nm ‫ߏݢ‬ୀෳ֎ӀॶǴ֎Ӏॶ‫ޑ‬ቚуᆶԼለὢ‫ޑ‬ᐚࡋԋ҅КǶ ϯᏢϸᔈԄ Creatinine + Picric acid ĺ Creatinine-Picrate complex(red) 7.ֿለ(Uric acid) ճҔ Uricase,Peroxidase ϩ ‫ ݤ ݋‬Ƕֿለ཮ӧֿለ䁙‫ޑ‬໽ϯΠౢғ allantoin Ϸၸ਼ϯణǴԶၸ਼ϯణΞ཮ᆶ 4-aminoantipyrine(4-AAP)Ϸ 3,5-dichloro-2-hydroxyl-benzene sulfonate(DCHBS)ӧၸ਼ϯ䁙‫ޑ‬໽ϯΠ‫׎‬ ԋ‫ڀ‬ԖᚑՅ‫ނޑ‬፦Ƕᔠᡏᆶ၂Ꮚ‫ޑ‬К‫ ࣁٯ‬1:25Ƕ‫ ܭ‬520nm ‫ߏݢ‬ୀෳ֎Ӏ ॶǴ֎Ӏॶ‫ޑ‬ቚуᆶֿለ‫ޑ‬ᐚࡋԋ҅КǶ ϯᏢϸᔈԄ uric acid + O 2 + H 2O ĺAllantoin + H2O2 +CO2 H2O2 + 4-AAP + DCHBS ĺ Quinoneimine + H 2O. 8.Ϻߐоữለᙯữ䁙(Aspartate aminotransferase, AST) ճҔ JSCC(Tris buffer) ϩ ‫ ݤ ݋‬Ƕ! ϯᏢϸᔈԄǺ! L-Aspartic acid + 2-oxoglutaric acid. oxaloacetic acid + L-glutamic acid Malate dehydrogenase oxaloacetic acid + NADH malic acid + NAD+ 26.

(35) ΢ॊϸᔈӧ 451on ‫ߏݢ‬ෳ‫ ۓ‬OBEI!֎Ӏࡋ‫ޑ‬෧ϿໆǴջёள‫ ډ‬BTU!‫ޑޑ‬ ࢲ‫܄‬Ƕ! 9.Чữለᙯữ䁙(Alanine aminotransferase, ALT) ճҔ KTDD ϩ ‫ ݤ ݋‬Ƕ! ϯᏢϸᔈԄǺ! L-Alanine + 2-oxoglutaric acid. Pyruvic acid. +. L-glutamic acid. ! ! ! Lactate dehydrogenase Pyruvic acid + NADHʳ Lactic acid + NAD+ !!!!!΢ॊϸᔈӧ 451on ‫ߏݢ‬ෳ‫ ۓ‬OBEI!֎Ӏࡋ‫ޑ‬෧ϿໆǴջёள‫ ډ‬BMU! ‫܄ࢲޑ‬Ƕ! !. 27.

(36) Ο!ǵ24 λਔӣᏫ‫ݤ‬՗ᆉ໯१ ! ! ӧჴᡍ߻җᔼᎦৣᆶ‫ڙ‬၂‫ޣ‬а΋ჹ΋‫ޑ‬БԄǴ௦ 24 λਔӣᏫ‫૶ݤ‬ ᒵǶҽໆ՗ᆉ߾а१‫ނ‬ኳࠠ‫ک‬Ѡ᡼த‫ـ‬१ࠔᔼᎦკ᠘‫ڐ‬շ՗ᆉǶ໯१इ ᒵᙯඤࣁख़ໆၗ਑Ǵ࿶᏾౛ࡕᒡΕႝတǴ٠ճҔаѠ᡼Ӧ୔१ࠔᔼᎦԋ ϩၗ਑৤ࣁЬाٰྍǴीᆉ዗ໆǵΟεᔼᎦનϷᑧ१ᠼᆢ፦‫ޑ‬ឪ‫ڗ‬ໆǶ ! ! !. 28.

(37) ಃѤ࿯ ಍ीᆶϩ‫݋‬ ԏ໣ኧᏵࡕа Microsoft Excel ຾Չϩ‫݋‬Ǵኧॶа meansrSD ߄ҢǴ а paired t test ಍ीӚਔ໔ᗺԖคৡ౦Ǵа unpaired t test ಍ी 2 ಔ໔Ԗค ৡ౦Ǵа p<0.05 ߄ҢԖ಍ीৡ౦Ƕ. 29.

(38) ಃѤക ่݀ ಃ΋࿯ ‫ڙ‬၂‫୷ޣ‬ҁၗ਑ ҁჴᡍӅ‫ܕ‬༅ 16 Տಃ 2 ࠠᑗֿੰੰ஻ୖуǴ࿶ᑔᒧၸࡕ٠ֹԋჴᡍ ‫ޣ‬Ӆी 14 ΓǴӚಔ‫ڙ‬၂‫ޣ‬ၗ਑‫߄ـ‬Β‫߄ک‬ΟǶ‫ڙ‬၂‫ޑޣ‬ѳ֡ԃសϩձ ࣁჴᡍಔ 54.8r9.3 ྃǴჹྣಔࣁ 51.1r5.7 ྃǶံк߻ჴᡍಔᡏख़ǵ‫ي‬ᡏ ፦ໆࡰኧȐBMIȑǵᡏિެϩձࣁ 63.5r11.0 ϦАǵ25.5r2.8 ϦА/ϦЁ 2ǵ 32.5r6.4%Ǵឦ‫ܭ‬ၸख़ᡏՏ; ჹྣಔᡏख़ǵ‫ي‬ᡏ፦ໆࡰኧȐBMIȑǵᡏિ ެϩձࣁ 70.7r11.4 ϦАǵ28.1r3.4 ϦА/ϦЁ 2ǵ37.9r6.8%Ǵឦ‫ޥܭ‬औ ᡏՏǶ. 30.

(39) ಃΒ࿯ ‫ڙ‬၂‫ޣ‬ᡏՏ‫ׯޑ‬ᡂ ံк 8 ຼࡕჴᡍಔ‫ک‬ჹྣಔ‫ڙ‬၂‫ޑޣ‬ᡏख़ϩձࣁ 62.8r10.8 ϦА‫ک‬ 69.8r11.4 ϦАǶံк 8 ຼࡕჴᡍಔ‫ڙ‬၂‫ޑޣ‬ᡏख़ၨံк߻Ԗᡉ๱‫ޑ‬Π फ़Ƕံк߻ჴᡍಔ‫ک‬ჹྣಔϐ‫ي‬ᡏ፦ໆࡰኧȐBMIȑϩձࣁ 25.5r2.8 Ϧ А/ϦЁ 2 ‫ ک‬28.1r3.4 ϦА/ϦЁ 2Ǵံк 8 ຼࡕჴᡍಔ‫ک‬ჹྣಔϐ‫ي‬ᡏ፦ ໆࡰኧȐBMIȑϩձࣁ 25.2r2.7 ϦА/ϦЁ 2 ‫ ک‬27.7r3.6 ϦА/ϦЁ 2Ǵ٠ ค ᡉ ๱ ৡ ౦ Ƕံк߻ჴᡍಔ‫ک‬ჹྣಔϐᡏિެϩձࣁ 32.5r6.4% ‫ک‬ 37.9r6.8%Ƕံк 8 ຼࡕჴᡍಔ‫ک‬ჹྣಔϐᡏિެϩձࣁ 30.6r5.5%‫ک‬ 36.7r7.6% Ƕ ჴ ᡍ ಔ ‫ ޑ‬ᡏ િ ެ ӧ ံ к 8 ຼ ࡕ ၨ ံ к ߻ Ԗ ᡉ ๱ Π फ़ (P<0.05) Ƕ. 31.

(40) ಃΟ࿯ ‫ڙ‬၂‫ޣ‬ϐ໯१ϩ‫݋‬ ‫ڙ‬၂‫ޣ‬ӧಃ 0ǵ4ǵ8 ຼа 24 λਔӣᏫ‫ڗ܌ݤ‬ள‫ޑ‬໯१ᔼᎦԋϩϩ ‫݋‬ӵ߄ѤǶಃ 0 ຼჴᡍಔឪ‫ڗ‬዗ໆ‫ޑ‬ѳ֡ࣁ 1605r318 εьǴೈқ፦ǵ િ ፦ ǵ ᅹ Н ϯ ӝ ‫ ނ‬Ϸ ᑧ१ᠼᆢ፦‫ ޑ‬ឪ ‫ ڗ‬ໆ ϩ ձ ࣁ 54.0r16.4 Ϧ լ ǵ 62.6r16.6 Ϧլǵ200r42.7 Ϧլǵ19.7r1.6 Ϧլ;ԶΟεᔼᎦન‫܌‬՞‫ޑ‬዗ ໆԭϩК 13.2%ǵ35.1%Ϸ 49.9%Ƕჹྣಔឪ‫ڗ‬዗ໆ‫ޑ‬ѳ֡ࣁ 1699r328 εьǴೈқ፦ǵિ፦ǵᅹНϯӝ‫ނ‬Ϸᑧ१ᠼᆢ፦‫ޑ‬ឪ‫ڗ‬ໆϩձࣁ 62.3r17.0 Ϧլǵ67.9r11.2 Ϧլǵ201.1r40.6 Ϧլǵ19.4r2.1 Ϧլ;ԶΟεᔼᎦન‫܌‬ ՞‫ޑ‬዗ໆԭϩКࣁ 14.5%ǵ36.1%Ϸ 47.3%Ƕံк 8 ຼࡕჴᡍಔឪ‫ڗ‬዗ໆ ‫ޑ‬ѳ֡ࣁ 1574r260 εьǴೈқ፦ǵિ፦ǵᅹНϯӝ‫ނ‬Ϸᑧ१ᠼᆢ፦‫ޑ‬ ឪ‫ڗ‬ໆϩձࣁ 60.7r13.3 Ϧլǵ57.6r11.0 Ϧլǵ196.3r38.1 Ϧլǵ24.2r1.5 Ϧլ;ԶΟεᔼᎦન‫܌‬э‫ޑ‬዗ໆԭϩК 15.1%ǵ32.5%Ϸ 50.4%Ƕံк 8 ຼࡕჹྣಔឪ‫ڗ‬዗ໆ‫ޑ‬ѳ֡ࣁ 1683r291 εьǴೈқ፦ǵિ፦ǵᅹНϯ ӝ‫ނ‬Ϸᑧ१ᠼᆢ፦‫ޑ‬ឪ‫ڗ‬ໆϩձࣁ 62.3r16.2 Ϧլǵ63.4r10.5 Ϧլǵ 207.7r32.7 Ϧլǵ19.5r1.8 Ϧլ;ԶΟεᔼᎦન‫܌‬э‫ޑ‬዗ໆԭϩКࣁ 14.6%ǵ33.9%Ϸ 49.5%Ƕӧჴᡍ߻ࡕ 2 ಔ‫ڙ‬၂‫ޣ‬ឪ‫ޑڗ‬዗ໆǵೈқ፦ǵ િ፦ǵᅹНϯӝ‫ނ‬೿ؒԖৡ౦Ƕᑧ१ᠼᆢ፦‫ޑ‬ឪ‫ڗ‬ໆӧಃ 4 ຼǵ8 ຼਔ ჴᡍಔܴᡉଯ‫ܭ‬ჹྣಔǶ. 32.

(41) ಃѤ࿯ Ոᑗǵી৞ન‫ک‬ᑗϯՈՅન‫ׯޑ‬ᡂ ‫ڙ‬၂‫ޣ‬ӧಃ 0ǵ4ǵ8 ຼϐՈᑗǵી৞નϷᑗϯՈՅન่݀ӵ߄ϖǶ 1. ჹ‫ޜ‬ဎՈᑗᐚࡋϐቹៜ ! ! ჴᡍಔӧံ к ߻ ‫ ံ ک‬к 4ຼ ࡕ ‫ ޜ ޑ‬ဎ Ո ᑗ ᐚ ࡋ ϩ ձ ࣁ 159.3r39.3 mg/dL‫ک‬147.3.0r31.6 mg/dLǴΠफ़Α7.5%Ȑp=0.07ȑǴံк8ຼࡕ‫ޑ‬໭߻ Ոᑗᐚࡋࣁ147.7r35.0 mg/dLǴၨံк߻Πफ़Α7.3%Ȑp=0.137ȑǶКၨ όӕಔձ‫ޜޑ‬ဎՈᑗᐚࡋว౜Ǵჴᡍಔ‫ک‬ჹྣಔӧံк4ຼϷံк8ຼ ਔ೿Ԗܴᡉ‫ޑ‬಍ी΢ৡ౦Ƕ 2.ჹ໭ࡕՈᑗᐚࡋᐚࡋϐቹៜ ჴᡍಔӧံ к ߻ ‫ ံ ک‬к 4ຼ ࡕ ‫ ޑ‬໭ ࡕ Ո ᑗ ᐚ ࡋ ϩ ձ ࣁ 194.9r40.2 mg/dL‫ک‬172.4r50.8 mg/dLǴΠफ़11.5%Ȑp=0.066ȑǶံк8ຼࡕ‫ޑ‬໭ࡕ Ոᑗᐚࡋࣁ175.3r23.6 mg/dLǴΠफ़10%Ȑp=0.129ȑǶКၨόӕಔձ‫ޑ‬ ໭ࡕՈᑗᐚࡋว౜Ǵჴᡍಔ‫ک‬ჹྣಔӧံк4ຼϷံк8ຼਔ೿Ԗܴᡉ ‫ޑ‬಍ी΢ৡ౦Ƕ 3.ჹՈమી৞નᐚࡋᐚࡋϐቹៜ ! ! ӧံкуሐᐪഝ߻Ǵჴᡍಔ‫ک‬ჹྣಔ‫ޑ‬Ոమી৞નᐚࡋ٠คᡉ๱ ৡ౦Ȑp=0.275ȑǴᐚࡋϩձࣁ13.9r3.9 PIU/mL‫ک‬20.8r14.6 PIU/mLǶ ӧံк4ຼ‫ک‬8ຼࡕǴКၨჴᡍಔ‫ک‬ჹྣಔ‫ޑ‬Ոమી৞નᐚࡋΨค಍ी΢ ϐৡ౦Ƕӧӕ΋ಔКၨόӕਔ໔ᗺΨว౜ǴᔼᎦीฝϟΕჹՈమી৞ન. 33.

(42) ᐚࡋΨค಍ी΢ཀကǶ 4.ჹᑗϯՈՅનϐቹៜ ! ! ჴᡍಔӧံк߻‫ံک‬кࡕϩձࣁ7.3r0.7%‫ک‬7.2r0.8%Ǵ٠ค෧Ͽ‫ޑ‬ ᖿ༈ǶКၨόӕಔձ‫ޑ‬ว౜ǴᑗϯՈՅનჴᡍಔ‫ک‬ჹྣಔӧံк߻ǵ ံк4ຼϷံк8ຼਔ೿Ԗܴᡉ‫ޑ‬಍ी΢ৡ౦Ƕ. 34.

(43) ಃϖ࿯ Ոિ፦ᐚࡋ‫ׯޑ‬ᡂ ‫ڙ‬၂‫ޣ‬ӧಃ 0ǵ4ǵ8 ຼϐᖌ‫ڰ‬ᎇǵΟለҒ‫✊ݨ‬ǵեஏࡋિೈқᖌ‫ڰ‬ ᎇϷଯஏࡋિೈқᖌ‫ڰ‬ᎇ่݀ӵ߄ϤǶ 1. ჹՈమᕴᖌ‫ڰ‬ᎇȐTCȑᐚࡋϐቹៜ ! ! ‫ڙ‬၂‫ޣ‬ӧံкуሐ‫ޑ‬ᐪഝ߻Ǵჴᡍಔ‫ک‬ჹྣಔ‫ޑ‬Ոమ TC ᐚࡋϩձࣁ 171.6r17.2 mg/dL ‫ ک‬187.1r39.9 mg/dLǴค಍ी΢ϐৡ౦Ƕ࿶ၸ 4 ຼ‫ ک‬8 ຼ‫ޑ‬уሐᐪഝံкว౜Ǵჴᡍಔ‫ک‬ჹྣಔ‫ޑ‬Ոమ TC ᐚࡋӧӕ΋ਔ໔Кၨ ֡ค಍ ी ΢ ϐ ৡ ౦ Ƕံк 8 ຼ่‫ࡕ״‬ǴՈమ TC ᐚࡋϩձࣁჴᡍಔ 172.3r14.2 mg/dL ‫ک‬ჹྣಔ‫ ޑ‬195.6r40.0 mg/dLǶံк߻ࡕӕ΋ಔӚਔ໔ ᗺ΢Ψ֡ค಍ी΢ϐৡ౦Ƕ 2. ჹՈమΟለҒ‫✊ݨ‬ȐTGȑᐚࡋϐቹៜ ! ! ჴ ᡍ ಔ ‫ ک‬ჹ ྣ ಔ ӧ ᔼ Ꭶ ी ฝ ϟ Ε ߻ ‫ ޑ‬Ո మ TG ᐚ ࡋ ϩ ձ ࣁ 102.9r36.9 mg/dL ‫ ک‬157.3r55.6 mg/dLǴԖ಍ी΢ϐৡ౦Ȑp<0.05ȑǶ ံк 8 ຼ่‫ࡕ״‬ǴՈమ TG ᐚࡋϩձࣁჴᡍಔ 124.1r67.5 mg/dL ‫ک‬ჹྣಔ ‫ ޑ‬174.3r75.7 mg/dLǴϩձ΢ϲΑ 21.2 mg/dL ‫ ک‬17 mg/dLǴ2 ಔ໔ค಍ ी΢ϐৡ౦Ƕံк߻ࡕӕ΋ಔӚਔ໔ᗺ΢Ψ֡ค಍ी΢ϐৡ౦Ƕ 3. ჹՈమեஏࡋિೈқᖌ‫ڰ‬ᎇȐLDL-Cȑᐚࡋϐቹៜ ! ! ӧံкуሐᐪഝ߻Ǵჴᡍಔ‫ک‬ჹྣಔ‫ޑ‬Ոమ LDL-C ᐚࡋϩձࣁ 108.1r22.4 mg/dL ‫ ک‬113.3r32.1 mg/dLǶ࿶ၸ 8 ຼ‫ޑ‬уሐᐪഝံкǴჴᡍ. 35.

(44) ಔ‫ک‬ჹྣಔ‫ޑ‬Ոమ LDL-C ᐚࡋঁձࣁ 100.7r21.8 mg/dL ‫ ک‬118.1r35.4 mg/dLΔϩձΠफ़ 6.8% ‫ ک‬1.0%Ǵ2 ಔ໔ؒԖ಍ी΢ৡ౦Ƕӕ΋ಔӚਔ໔ ᗺ΢Ψ֡ค಍ी΢ϐৡ౦Ƕ 4. ჹՈమଯஏࡋિೈқᖌ‫ڰ‬ᎇȐHDL-Cȑᐚࡋϐቹៜ !. ‫ڙ‬၂‫ޣ‬ӧಃ 0ǵ4ǵ8 ຼǴՈమ HDL-C ᐚࡋჴᡍಔᆶჹྣಔКၨ٠ค. ಍ी΢ϐৡ౦Ƕჴᡍಔӧံк߻‫ံک‬кࡕϐ HDL-C ᐚࡋϩձࣁ 45.4r11.6 mg/dL ‫ ک‬46.9r14.6 mg/dLǴౣࣁ΢ϲΑ 3.3%Ƕჹྣಔံк߻‫ံک‬кࡕϐ HDL-C ᐚࡋϩձࣁ߾ࣁ 42.3r9.7 mg/dL ‫ ک‬43.7r8.4 mg/dLǶံк߻ࡕӕ΋ ಔӚਔ໔ᗺ΢Ψ֡ค಍ी΢ϐৡ౦Ƕ. 36.

(45) ಃϤ࿯ ჹ‫ط‬фૈࡰኧ‫ޑ‬ቹៜ ‫ڙ‬၂‫ޣ‬ӧಃ 0ǵ4ǵ8 ຼϐ AST ‫ ک‬ALT ่݀ӵ߄ΎǶҗ่࣮݀рǴ ံкᐪഝ‫ک‬ჹྣಔ‫ ޑ‬AST ‫ ک‬ALTǴӧჴᡍය໔ᐚࡋ֡คܴᡉᡂϯǴࣣ ӧ҅தጄൎॶϣȐλ‫ ܭ‬40 IU/LȑǴᡉҢрံк֖ሐ‫ޑ‬ᐪഝჹ‫ؒ᠌ط‬Ԗ ҺՖቹៜǶ. 37.

(46) ಃΎ࿯ ჹ๝фૈࡰኧ‫ֿک‬ለ‫ޑ‬ቹៜ ‫ڙ‬၂‫ޣ‬ӧಃ 0ǵ4ǵ8 ຼϐֿለǵՈమֿનේȐBUNȑ‫ک‬Լለὢ Ȑcreatinineȑ่݀ӵ߄ΖǶ๝᠌фૈࡰኧᔠෳՈమֿનේȐBUNȑ‫ک‬ ԼለὢȐcreatinineȑᐚࡋǶҗ่࣮݀рǴჴᡍಔ‫ک‬ჹྣಔӧᔼᎦीฝϟ Εය໔Ոమ BUN ‫ک‬Լለὢᐚࡋ֡คܴᡉᡂϯǴЪ೿҅தጄൎॶϣǴᡉ Ңрံкуሐ‫ޑ‬ᐪഝჹ๝᠌ؒԖҺՖቹៜǶӧՈమֿለᐚࡋ೽ϩǴ‫ٿ‬ ಔ࿶ၸ 8 ຼϐᔼᎦϟΕਔǴֿለᐚࡋࣣၨϟΕ߻ਔᐚࡋԖᡉ๱ቚଯ‫ޑ‬ ᖿ༈ǴԶᐚࡋ೿ӧ҅தጄൎॶϣȐ҅தॶɦ8 mg/dLȑǶ. 38.

(47) ಃϖക ૸ፕ ಃ΋࿯ ‫ڙ‬၂‫ޣ‬ᡏՏ‫ׯޑ‬ᡂ‫ک‬໯१ឪ‫ڗ‬௃‫׎‬ ҁჴᡍ่݀ᡉҢуሐᐪഝಔ‫ڙ‬၂‫ޑޣ‬ᡏख़ᕴӅΠफ़ 0.7 ϦАǴჹྣಔ Πफ़ 0.9 ϦА;ᡏિެϩձΠफ़ 1.9%‫ ک‬1.2%ǶКၨ‫ࡕ߻ځ‬዗ໆឪ‫ڗ‬ৡ౦ όεǴՠિެឪ‫ޑڗ‬К‫ٯ‬ϩձΠफ़Α 1.6%‫ ک‬3%Ƕ೭ёૈࢂᡏख़‫ک‬ᡏિ ެΠफ़‫ޑ‬চӢǶќѦНྋ‫܄‬ᑧ१ᠼᆢ፦ё‫ۯ‬጗௨‫ޜ‬ǴቚуႫ१གǴ෧Ͽ ຾१ΨёૈࢂচӢϐ΋Ƕ ٩Ᏽҁჴᡍԏ໣‫ޑ‬ၗ਑ள‫ ޕ‬2 ಔ‫ޑ‬ѳ֡ឪ‫ڗ‬዗ໆӧჴᡍ߻ࡕ٠คৡ ౦ǶΟεᔼᎦનύჴᡍಔӧೈқ፦ឪ‫ܴڗ‬ᡉ΢ϲǴિެΠफ़; ჹྣಔӧિ ެឪ‫ܴڗ‬ᡉΠफ़ǶᅹНϯӝ‫ ނ‬2 ಔӧჴᡍ߻ࡕ٠คৡ౦Ƕჴᡍಔ‫ޑ‬ᑧ१ᠼ ᆢ፦ӧჴᡍಃ 4ǵ8 ຼӢံкуሐᐪഝԖᡉ๱ৡ౦Ƕӧҁჴᡍा‫܌؃‬Ԗ‫ڙ‬ ၂‫ޣ‬ᆢ࡭ѳВ໯१ಞᄍǴՠёૈ೭٤ಃ 2 ࠠᑗֿੰ஻‫ޣ‬࿶ၸΑᙴៈΓ঩‫ޑ‬ ፁ௲‫܈‬வൔകᚇᇞᕇள࣬ᜢၗૻǴ٠ჹуΕჴᡍԶԖ‫܌‬ය೚Ǵ໯१Бय़Ԗ ෧ϿొፓҔ‫ݨ‬ǵϿӞᖌ‫ڰ‬ᎇଯ‫ޑ‬१‫ނ‬฻௃‫׎‬Ƕ ᅹНϯӝ‫ޑނ‬ឪ‫ڗ‬ໆ՞‫ޑ‬዗ໆԭϩКࣁ 49.9%‫ ک‬47.3%Ǵᆶऍ୯ᑗֿ ੰ‫཮ڐ‬ӧ 2000 ԃჹᅹНϯӝ‫ࡌޑނ‬᝼эᕴ዗ໆ‫ ޑ‬50-60%КၨǴҁჴᡍ‫ޑ‬ ‫ڙ‬၂‫ޣ‬ឪ‫ڗ‬ᅹНϯӝ‫ޑނ‬К‫ٯ‬ၨեǴ௢ෳёૈࢂҗ‫ܭ‬ε೽ҽ‫ޑ‬ᑗֿੰ஻‫ޣ‬ ᇡࣁឪ‫ڗ‬ၸӭᅹНϯӝ‫ࢂނ‬ᏤठՈᑗ௓‫ڋ‬ό٫‫ޑ‬ख़ाচӢǶ ჴᡍ߻ೈқ፦‫ޑ‬ឪ‫ڗ‬ໆэ‫ޑ‬዗ໆԭϩКϩձࣁ 13.2%‫ ک‬14.5%Ǵ8 ຼ. 39.

(48) ࡕჴᡍಔೈқ፦‫ޑ‬ឪ‫ڗ‬ໆ΢ϲԿ 15%Ǵՠ֡ӧऍ୯ᑗֿੰ‫ࡌ཮ڐ‬᝼‫ޑ‬ጄ ൎϐύǶԖࣴ‫ࡰز‬рόፕࢂ҅த‫ڙ‬၂‫ࢂ܈ޣ‬ಃ 2 ࠠᑗֿੰ஻‫ޣ‬ឪ‫ڗ‬ೈқ፦ ࡕ֡ό཮ቚуՈᑗᐚࡋ(Khan et al., 1992; Westphal et al., 1990; Gannon et al., 1992; Nuttall and Gannon, 1991)Ƕ җ‫ܭ‬ᑗֿੰ஻‫ޣ‬ᆶᑡ஻߷Ј٠ԖஏϪᜢ߯ǴӢԜऍ୯ᑗֿੰ‫ࡌ཮ڐ‬᝼ ‫؂‬Вિެឪ‫ڗ‬ໆᔈϿ‫ܭ‬ᕴ዗ໆ‫ ޑ‬30%ǴЪႫ‫ک‬િެለᔈե‫ܭ‬ᕴ዗ໆ 10%Ƕ ӧ ҁ ჴ ᡍ ߻ ‫ ڙ‬၂ ‫ ޑ ޣ‬િ ެ ឪ ‫ ڗ‬ໆ э ‫ ޑ‬዗ ໆ ԭ ϩ К ϩ ձ ࣁ 35.1% ‫ک‬ 36.1%Ǵӧ 8 ຼࡕϩձࣁ 33.4%‫ ک‬33%ǴᗨԖΠफ़ՠϝ֡ଯ‫ܭ‬ऍ୯ᑗֿੰ ‫ࡌޑ཮ڐ‬᝼ໆǴ௢ෳচӢёૈࢂ‫ڙ‬၂‫ޣ‬Ѧ१ᐒ཮ӭǴ14 Տ‫ڙ‬၂‫ޣ‬ύԖ 11 Տ‫؂‬ВԿϿ΋ᓓࣁѦ१ǴЪᆶύ୯਑౛ଯ‫ݨ‬િొፓБ‫ݤ‬ԖᜢǶ ऍ୯ᑗֿੰ‫ࡌ཮ڐ‬᝼ᑧ१ᠼᆢ፦ࡌ᝼ໆᔈࣁ‫؂‬В 20-35 ϦլǴ٠மፓ ӄ⟻ᜪǵጫ๼ϷН݀฻ᅹНϯӝ‫ޑྍٰނ‬ӳೀǶჴᡍ߻‫ڙ‬၂‫ޑޣ‬ᑧ१ᠼᆢ ፦ឪ‫ڗ‬ໆϩձࣁ 19.7 Ϧլ‫ ک‬19.4 Ϧլၨࡌ᝼ໆեǴჴᡍಔӧံк֖ሐᐪ ഝࡕёӆቚу 4.95 Ϧլᑧ१ᠼᆢ፦ǶਥᏵಃΟԛ୯҇ᔼᎦፓࢗࡰр୯Γ ᠼᆢ፦ឪ‫ڗ‬ໆܴᡉόଯǴӵՖගϲ୯Γ‫ޑ‬ᠼᆢ፦ឪ‫ڗ‬ໆࢂ΋ख़ाፐᚒǶऩ ૈ‫ܭ‬໯१ύқԯ໭‫܈‬қរх฻ᆒᇙϐ⟻ᜪ१‫ނ‬Ǵаӄ⟻ᜪ‫ڗ‬жӵԜёቚу ⟻ᜪ‫ޑ‬ᔼᎦሽॶΨёफ़եӚᅿᄌ‫܄‬੯ੰ‫ޑ‬Ӓᓀ‫܄‬Ƕ! !. 40.

(49) ಃΒ࿯ Ոᑗϐᡂϯ ! ! ӧҁԛ‫ޑ‬ᔼᎦीฝϟΕύჴᡍಔӧံк߻‫ံک‬к 4 ຼࡕ‫ޜޑ‬ဎՈ ᑗᐚࡋǴΠफ़Α 7.5%Ǵံк 8 ຼࡕ‫ޑ‬໭߻ՈᑗᐚࡋǴၨံк߻Πफ़Α 7.3%Ƕჴᡍಔӧံк߻‫ံک‬к 4 ຼࡕ‫ޑ‬໭ࡕՈᑗᐚࡋΠफ़ 11.5%Ƕံк 8 ຼࡕ‫ޑ‬໭ࡕՈᑗᐚࡋΠफ़ 10%Ƕံкࡕ 4 ຼ‫ ک‬8 ຼჴᡍಔᆶჹྣಔϐ ‫ޜ‬ဎ‫ک‬໭ࡕՈᑗ֡Ԗᡉ๱ৡ౦ǶEvans ӧ 1989 ԃϷ Ghosh ฻Γ 2002 ԃ ‫ࡰزࣴޑ‬рံк 200 ȝg ‫ޑ‬ሐံкᏊჹಃ 2 ࠠᑗֿੰΓ‫ޑ‬Ոᑗ‫ک‬ᑗϯՈ Յન೿ԖΠफ़‫(่݀ޑ‬Evans , 1989; Ghosh et al., 2002 )ǶԜ่݀ᆶҁჴ ᡍ่݀ႜӕǴᡉҢ‫؂‬Вံкሐ֖ໆ 200 ȝg ‫ޑ‬ᐪഝТǴёа‫ׯ‬๓Ոᑗ‫ޑ‬ ‫ݩރ‬Ƕံк 8 ຼࡕ໭߻໭ࡕՈᑗ‫ޑ‬Πफ़ǴচӢନΑబуሐ‫ޑ‬ӢનѦǴ ၟᐪഝТύᑧ१ᠼᆢ፦ԖᜢǶӢࣁᑧ१ᠼᆢ፦ё‫ۯ‬጗ग௨‫ޜ‬ǴቚуႫ१ གǴ෧Ͽ຾१Ǵҭё጗‫ک‬Ոనൻᕉ֎ԏဟ๻ᑗ‫ޑ‬ϸᔈǶ ќ΋ঁᅱ௓ᑗֿੰ‫ޑ‬ғϯॶᑗϯՈՅનǴѬࢂᑗֿੰ஻ख़ा‫ޑ‬Ո ᑗ௓‫ࡰڋ‬኱ǴՈዀύ‫ޑ‬ဟ๻ᑗߕ๱ӧआՈౚ‫ޑ‬ՈՅનǴวғᑗϯբҔǴ Ԝၸำࢂ൳Яόё଍‫ޑ‬ǶᑗϯբҔຫӭǴኧॶ൩ຫଯǶҗ‫ܭ‬आՈౚ‫ޑ‬ტ‫ڮ‬ ࣁ 120 ϺǴԜᔠᡍϸࢀр၀ਔࢤϣ‫ޑ‬ՈᑗᐚࡋǶਥᏵ 1998 ԃम୯ᑗֿੰ ߻ᘳ‫زࣴ܄‬ᡉҢᑗϯՈՅન௓‫ڋ‬ӧ 7.0%‫ޣ‬ၨ௓‫ڋ‬ӧ 7.9%‫ޣ‬Ǵวғᑗֿ ੰ‫ٳ‬วੱӒᓀ‫܄‬ё෧Ͽ 12%Ǵᑗֿੰ࣬ᜢԝΫ౗෧Ͽ 10%ǴԶᕴԝΫ౗ё ෧Ͽ 6%(Turner et al., 1998)Ƕҁࣴ‫ز‬ύჴᡍಔϐᑗϯՈՅનӧံк߻൩. 41.

(50) ၨჹྣಔԖᡉ๱ৡ౦Ǵံк 4 ຼ‫ ک‬8 ຼࡕᗨᆶჹྣಔԖᡉ๱ৡ౦Ǵՠคཀ ကǶLee ฻Γӆ 1994 ԃ‫زࣴޑ‬ύа 30 Տᑗֿੰ஻‫ࣁޣ‬ჹຝǴ๏ϒ‫؂‬Вሐ ံкᏊ 200 ȝgǴ2 ঁДࡕჹᑗϯՈՅનค‫ׯ‬๓Ƕՠ Ravina ฻Γ‫ࡰزࣴޑ‬р ‫؂‬ВሐံкᏊ 200 ȝgǴᑗϯՈՅનΠफ़(Ravina et al.,1999)ǶӢԜ໯१ύబ уሐჹᑗϯՈՅન‫ޑ‬ቹៜǴሡ‫׳‬຾΋‫؁‬௖૸Ƕ. 42.

(51) ಃΟ࿯ Ոિ፦ϐᡂϯ ᑗֿੰ஻‫ޣ‬ऩӝ‫ٳ‬ԖଯՈᓸǵՈિ౦தϷ‫ޥ‬औਔǴᑡ஻߷Јੰ‫ޑ‬Ӓᓀ ‫܄‬ΨᒿϐቚуǴӢԜନΑ௓‫ڋ‬ՈᑗǴफ़եՈિ፦ࢂᑗֿੰ஻‫ޣ‬ႣٛεՈᆅ ੰᡂ‫܌‬ሡոΚ‫ޑ‬Ҟ኱Ƕ! ࣴ‫ز‬ᡉҢ൤֖ᑧ१ᠼᆢ፦‫ޑ‬໯१ёа‫ׯ‬๓ᑗֿੰ஻‫ޑ‬Ոᑗ௓‫ڋ‬Ǵफ़ե Ոనύᕴᖌ‫ڰ‬ᎇϷ LDL-C ໆ)Simpson et al., 1979; Lousley et al., 1984*!Ƕ! ᑧ१ᠼᆢ፦Ξа൤֖Нྋ‫܄‬ᑧ१ᠼᆢ፦‫ޑ‬ਏ݀‫ࣁ׳‬ᡉ๱)Simpson et al., 1981*ǶӢࣁᑧ१ᠼᆢ፦ёᆶᖌለ่ӝǴ٠ቚуᕨߡύᖌለ‫ޑ‬௨‫ݧ‬Ǵ෧Ͽ ᖌለ࿶җဉ‫ط‬ൻᕉ֎ԏӣ‫;᠌ط‬ቚуᖌለӝԋ 7͉-hydroxylase ‫܄ࢲޑ‬Ǵ٬ ᖌለӝԋቚуǴ຾Զफ़եՈనύᖌ‫ڰ‬ᎇᐚࡋ(Garcia-Diez et al., 1996)ǶԜ Ѧᑧ१ᠼᆢ፦Ψёᡣဉၰ༾ғ‫ނ‬ϩှౢғอ᜘િެለǴё‫ڋ׭‬િެለӝ ԋǴफ़եᖌ‫ڰ‬ᎇӧՈమϷ‫᠌ط‬ύ୴ᑈǶ! ҁࣴ‫ز‬ӧံкΑуሐᐪഝ 8 ຼࡕՈనύեஏࡋિೈқᖌ‫ڰ‬ᎇᐚࡋၨ ံк߻Πफ़Α 6.8%Ƕଯஏࡋિೈқᖌ‫ڰ‬ᎇᐚࡋၨံк߻ౣࣁቚуΑ 3.3%ǶՈమ TG ᐚࡋ΢ϲΑ 20.6%Ǵค಍ी΢ϐৡ౦Ƕᕴᖌ‫ڰ‬ᎇΨ٠ؒ Ԗᡉ๱ৡ౦Ƕ1999 ԃ Anderson ฻Γаᑗֿੰӝ‫ٳ‬ଯᖌ‫ڰ‬ᎇ‫ޑ‬஻‫ࣁޣ‬ჹ ຝǴࣴ‫ز‬ว౜‫؂‬ϺᚐѦံкᑧ१ᠼᆢ፦Ǵ8 ຼࡕՈዀύᖌ‫ڰ‬ᎇᡉ๱फ़ե 8.9%Ǵ եஏࡋિೈқᖌ‫ڰ‬ᎇᡉ๱फ़ե 13% (Anderson et al., 1999)Ƕҁࣴ‫ز‬ ٠คӵԜ่݀Ǵ চӢёૈࢂ‫ٿ‬ಔ‫ޑ‬Ոύᕴᖌ‫ڰ‬ᎇѳ֡ᐚࡋࣣλ‫ ܭ‬200. 43.

(52) mg/dL аΠǴԶՈύեஏࡋિೈқᖌ‫ڰ‬ᎇѳ֡ᐚࡋΨ೿λ‫ ܭ‬130 mg/dL а ΠǴ‫܌‬аံк֖ሐ‫ޑ‬ᐪഝ٠ؒԖᢀჸ‫ܴډ‬ᡉ‫ׯޑ‬๓Ոિ፦Ǵ҂ٰёଞჹ‫ڀ‬ ԖՈિ౦தϐᑗֿੰ஻‫ޣ‬уа຾Չࣴ‫ز‬ᆶ૸ፕǶ ԜѦ Uusitupa ฻Γӧ 1983 ԃ‫ ک‬Ghosh ฻Γ 2002 ԃ‫زࣴޑ‬ύಃ 2 ࠠ ᑗֿੰ஻‫؂ޣ‬Вံк 200 ȝg ‫ޑ‬ሐံкᏊǴϩձ຾Չ 6 ຼ‫ ک‬3 ঁД‫ځ‬Ոિ ፦٠҂‫ׯ‬ᡂ(Uusitup et al., 1983; Ghosh et al., 2002)ǶԶ 1997 ԃ Anderson ฻Γ‫زࣴޑ‬ύࢂ๏ಃ 2 ࠠᑗֿੰ஻‫؂ޣ‬Вံк 1000 ȝg ‫ޑ‬ሐံкᏊǴߏၲ 4 ঁДǴ่݀ᕴᖌ‫ڰ‬ᎇᡉ๱Πफ़(Anderson et al., 1997)ǶӢԜ‫؂‬В 200 ȝg ‫ޑ‬уሐᐪഝჹಃ 2 ࠠᑗֿੰ஻‫ޑޣ‬Ոિ፦٠คቹៜǶ҂ٰёଞჹගଯሐ ‫֖ޑ‬ໆ‫ޑزࣴߏۯ܈‬ਔ໔уа຾Չࣴ‫ز‬ᆶ૸ፕǶ !. 44.

(53) ಃϤക ่ፕ ӧҁԛჴᡍύǴ่݀ᡉҢჴᡍಔӧံкуሐᐪഝ4ຼࡕ‫ޜޑ‬ဎՈᑗၨ ံк߻ਔΠफ़7.5 %Ǵ8ຼံк่‫״‬ၨံк߻ਔΠफ़7.3 % Ƕ໭ࡕՈᑗӧံ к4ຼࡕၨံк߻ਔΠफ़11.5 %Ǵ8ຼံк่‫ࡕ״‬ၨံк߻ਔΠफ़10.1 %Ǵ ံк4ຼ‫ک‬8ຼࡕ‫ޜ‬ဎ‫ک‬໭ࡕՈᑗ֡ᆶჹྣಔԖᡉ๱ৡ౦ǶՈિ፦όፕΟለ Ғ‫✊ݨ‬ǵᕴᖌ‫ڰ‬ᎇǵեஏࡋિೈқᖌ‫ڰ‬ᎇǵଯஏࡋિೈқᖌ‫ڰ‬ᎇǴӧჴᡍ ಔ‫ک‬ჹྣಔϐ໔คৡ౦Ǵံк߻‫ံک‬кࡕΨคৡ౦ǶᡉҢ໯१ύబууሐ ᐪഝёа‫ׯ‬๓ಃ2ࠠᑗֿੰ஻‫ޣ‬ϐՈᑗᐚࡋǶ. 45.

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(63) Uusitupa MI, Kumpulainen JT, Voutilainen E, Hersio K, Sarlund H, Pyorala KP, Koivistoinen PE, Lehto JT (1983) Effect of inorganic chromium supplementation on glucose tolerance, insulin response, and serum lipids in noninsulin-dependent diabetics.. Am J Clin Nutr 38:404-410.. Venn BJ, Mann JI (2004) Cereal grains, legumes and diabetes.. Eur J Clin. Nutr 58(11):1443-1461. Westphal SA, Gannon MC, Nuttall FQ (1990) The metabolic response to glucose ingested with various amounts of protein. Am J Clin Nutr 52:267-272.. Winblad I, Joensuu T, Korpela H (1995) Effect of oat bran supplemented diet on hypercholesterolemia.. Scand J Prim Health Care 13:118-121.. Wolever TMS, Katzman-Relle L, Jenkins AL (1994) Glycaemic index of 102 complex carbohydrate in patients with diabetes.. Nutr Res 14: 651–669.. Wursch P, Pi-Sunyer FX (1997) The role of viscous soluble fiber in the metabolic control of diabetes. rich in beta-glucan.. A review with special emphasis on cereals. Diabetes Care 20:1774 -1780.. Zavaron I, Bonora E, Pagliara M, Dallaglio E, Luchetti L, Buonanno G, Bonati PA, Bergonzani M, Gnudi L, Passeri M, Reaven G (1989) Risk factors for coronary artery disease in healthy persons with hyperinsulinemia and normal glucose tolerance.. N Eng J Med 320:702-706.. 55.

(64) Ѡ᡼࣪தҔ१ࠔϐᔼᎦԋϩ!(1975) Ѡ᡼࣪஁Ѵፁғࣴ‫܌ز‬ጓΖʳ ഡ଻Ӏǵഋ‫ذ‬ዝǵϜ‫ד‬மǵഋඳο!(1998) Ѡ᡼Ӧ୔१ࠔᔼᎦԋϩၗ਑৤Ǵ Չࡹଣፁғ࿿‫ہ‬ᒤǵ१ࠔπ཰ว৖ࣴ‫܌ز‬ጓӑΖʳ ߎඁ҇ǵЦ‫ذ‬ൟǵ߉᝶๩ǵ᝵‫ذ‬৹ǵ‫ࣿڬ‬ᐪǵഋ۩‫ە‬ǵֈऍᅈ (1998)!Ѡ ᡼த‫ـ‬१ࠔᔼᎦკ᠘ǴΟैᕴᙴଣᔼᎦ೽ጓΖ. 56.

(65) ߄΋ǵᐪഝТԋϩ Table1.Composition of the oatmeal ԋϩ. ‫ ؂‬100 լ. ዗ໆ. 347 εь. ೈқ፦. 12.5 լ. િ፦. 7.3 լ. ᅹНϯӝ‫ނ‬. 69.4 լ. ໊. 4.4 డլ. ᑧ१ᠼᆢ፦. 9.9 լ. ͊-ᆫဟ๻ᑗ. 5լ. ሐ. 400 ༾լ. 57.

(66) ߄Βǵ‫ڙ‬၂‫ံޣ‬к߻ϐ୷ҁၗ਑ 1 Table 2. Characteristics of study subjects before supplementation1 ໨Ҟ ჴᡍಔ ჹྣಔ ΓኧȐՏȑ. 7. 7. ԃសȐྃȑ. Γ54.8r9.3. 51.1r5.7. ‫ي‬ଯȐϦϩȑ. 157r7. 158r6. ᡏख़ȐϦАȑ. 63.5r11. 70.7r11.4. 1ኧᏵаmeans r SD߄ҢǶ. 58.

(67) ߄Οǵ‫ڙ‬၂‫ޣ‬ϐᡏख़ǵ‫ي‬ᡏ፦ໆࡰኧǵᡏિެ1 Table 3. Change in body weightǵbody mass indexǵbody fat of study subjects1 ຼኧ2 ჴᡍಔ ჹྣಔ ᡏख़ȐϦАȑ 0. 63.5r11.0a. 70.7r11.4. 4. 63.4r11.0 a. 70.7r11.4. 8. 62.8r10.8 b. 69.8r11.4. 0. 25.5r2.8. 28.1r3.4. 4. 25.4r2.8. 28.0r3.4. 8. 25.3r2.7. 27.7r3.6. 0. 32.5r6.4 a. 37.9r6.8. 4. 31.6r5.5 a. 36.7r7.6. 8. 30.6r5.5 b. 36.7r7.6. ‫ي‬ᡏ፦ໆࡰኧ ȐϦА/ϦЁ2ȑ. ᡏિެ(%). 1. Data are expressed as means r SD. ຼኧǺ0߄Ңჴᡍය໒‫ۈ‬Ǵ4߄ҢჴᡍයಃѤຼǴ8߄ҢჴᡍයಃΖຼ่‫״‬Ƕ a,b ӧӕ΋ಔ໔Ԗόӕ΢኱಄ဦ߄Ң‫ڀ‬Ԗ಍ीৡ౦Ƕ 2. 59.

(68) ߄Ѥǵ዗ໆϷΟεᔼᎦનϐѳ֡ឪ‫ڗ‬ໆ1 Table 4. Average daily intake of energy, protein, fat, carbohydrate, dietary fiber1 ຼኧ2 ჴᡍಔ ჹྣಔ n=7 n=7 ዗ໆȐεьȑ 0. 1605r318. 1699r328. 4. 1578r283. 1659r289. 8. 1574r260. 1683r291. ೈқ፦ȐϦլȑ. Γ 0. 54.0r16.4a. 62.3r17.0. 4. 60.9 r16.3 b. 61.3 r15.7. 8. 60.7 r13.3 b. 62.3 r16.2. 0. 62.6r16.6. 67.9r11.2a. 4. 58.9r11.0. 63.3r9.8 b. 8. 57.6r11.0. 63.4r10.5 b. 0. 200r42.7. 201.1r40.6. 4. 194.1r40.7. 203.9r36.8. 8. 196.3r38.1. 207.7r32.7. 0. 19.7r1.6 a. 19.4r2.1. 4. 24.3r1.4 b*. 19.4r1.9. 8. 24.2r1.5 b*. 19.5r1.8. િ፦ȐϦլȑ. ᅹНϯӝ‫ނ‬ȐϦլȑ. ᑧ१ᠼᆢ፦ȐϦլȑ. 1ኧᏵаmeans r SD߄ҢǶ 2ຼኧǺ0߄Ңჴᡍය໒‫ۈ‬Ǵ4߄ҢჴᡍයಃѤຼǴ8߄ҢჴᡍයಃΖຼ่‫״‬Ƕ a,b ӧӕ΋ಔ໔Ԗόӕ΢኱಄ဦ߄Ң‫ڀ‬Ԗ಍ीৡ౦Ƕ * ߄ҢᆶჹྣಔКၨ‫ڀ‬Ԗ಍ी΢ৡ౦Ƕ 60.