ตำราวิชาการ-อาหารเพื่อสุขภาพ-หน้า-312-690 (1)

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∫∑∑’Ë 11 565 °“√Õ¥Õ“À“√·≈–°“√®”°—¥·§≈Õ√’ ∫∑∑Ë’ 11 °“√Õ¥Õ“À“√·≈–°“√®”°¥— ·§≈Õ√’ (Fasting and Caloric Restriction) ¥√. ‰™¬¬ß √®ÿ ®π‡«∑ ∫∑π” °“√Õ¥Õ“À“√ (Fasting) À¡“¬∂÷ß°“√ߥ∫√‘‚¿§Õ“À“√‡ªìπ√–¬– ≈—∫°—∫°“√∫√‘‚¿§ Õ“À“√ (Intermittent fasting, IF)  ”À√—∫°“√®”°¥— ·§≈Õ√’ (Caloric restriction, CR) À¡“¬∂÷ß °“√®”°—¥ª√‘¡“≥æ≈—ßß“π∑’Ë∫√‘‚¿§ ·µà¬—ߧß∫√‘‚¿§ “√Õ“À“√ÕË◊πÊ ‡™àπ «‘µ“¡‘π·≈–‡°≈◊Õ·√à µà“ßÊ ∑—Èß°“√Õ¥Õ“À“√·≈–°“√®”°—¥·§≈Õ√’≈â«π¡’«—µ∂ÿª√– ß§åÀ≈—°‡æË◊Õ°“√¡’™à«ßÕ“¬ÿ ÿ¢¿“楒 ∑Ë’¬π◊ ¬“« (long health span) ·≈–¡’Õ“¬√ÿ «¡¬◊𬓫 (long life span) ¡π…ÿ ¬å‰¥ â ß— ‡°µ«“à ¢≥–∑ Ë’ µ— «å‰¡ à ∫“¬ ¡π— ®–‰¡°à π‘ Õ“À“√ ´ß÷Ë ‡ªπì ‰ªµ“¡ ≠— ™“µ≠“≥ ¢Õß Ë‘ß¡’™’«‘µ∑Ë’µâÕß°“√ ß«πæ≈—ßß“π∑Ë’„™â„π°“√¬àÕ¬Õ“À“√‡æ◊ËÕ‰«â„™âµàÕ Ÿâ°—∫§«“¡‡®Á∫ªÉ«¬ ‚¥¬ ∏√√¡™“µ‘ °“√‰¥â¡“´÷ËßÕ“À“√‡ªìπªí®®—¬∑’Ë ”§—≠¡“°ª√–°“√ÀπË÷ß„π°“√°”Àπ¥æƒµ‘°√√¡ µà“ßÊ ¢Õß Ë‘ß¡’™’«‘µ °“√‰¥â√—∫Õ“À“√„πª√¡‘ “≥∑’ˉ¡à‡æ’¬ßæÕ‡ªìπæ≈—ߢ—∫¥—π∑’Ë ”§—≠ ∑”„À â ß‘Ë ¡’™’«µ‘ ¡’°‘®°√√¡∑’ˇ§≈◊ËÕπ‰À«Õ¬àŸ‡ ¡Õ ‰¡à‡©Ë◊Õ¬™“ π—∫·µàÕ¥’µ°“≈ °“√Õ¥Õ“À“√¬—ß∂◊Õ‡ªìπ°“√∫”‡æÁ≠  ¡“∏‘™π‘¥Àπ÷Ëß ´÷Ëß¡’Õ¬àŸ„π«‘∂’ªØ‘∫—µ‘¢Õß∑ÿ°»“ π“ (µ“√“ß∑’Ë 1) ‡™Ë◊Õ°—π«à“°“√Õ¥Õ“À“√¡‘‰¥â‡ªìπ ·µà‡æ’¬ß·§à°“√≈â“ßæ‘…ÕÕ°®“°√à“ß°“¬ (body detoxification) ·≈–¬—ß™”√–≈â“ß®‘µ„®Õ’°¥â«¬ ‡æ√“–µÕâ ß≈¥°‘‡≈ §«“¡¬“° §«“¡‚≈¿≈ߥ«â ¬ °“√Õ¥Õ“À“√®÷ß∂◊Õ«à“‡ªìπ¢È—πµÕπ·√°¢Õß°“√¥Ÿ·≈ ÿ¢¿“æ·∫∫Õߧå√«¡∑“ß∏√√¡™“µ‘ (natural holistic medicine) ‡æ◊ËÕ∑’Ë®–„Àâ√à“ß°“¬‰¥â√—∫Õ“À“√∑’Ë¥’°«à“‡¢â“ Ÿà√à“ß°“¬ ·≈– √â“ß §«“¡ ¡¥ÿ≈∑“ß‚¿™π“°“√ ‡ªπì º≈¥µ’ àÕ ¢ÿ ¿“æÕ¬à“ß ¡∫√Ÿ ≥åµàÕ‰ª °Õß°“√·æ∑¬å∑“߇≈Õ◊ ° °√¡æ≤— π“°“√·æ∑¬·å ºπ‰∑¬·≈–°“√·æ∑¬å∑“߇≈Õ◊ °

566 µ”√“«™‘ “°“√ Õ“À“√‡æ◊ÕË  ¢ÿ ¿“æ µ“√“ß∑’Ë 1 °“√Õ¥Õ“À“√„π«‘∂ª’ Ø‘∫—µ‘¢Õß»“ π“µ“à ßÊ »“ π“ «“√–·≈–¢âժؑ∫µ— ‘ ®¥ÿ ¡ßÿà À¡“¬ ∫“‰Œ ߥ°“√∫√‘‚¿§Õ“À“√·≈–‡§√ËÕ◊ ߥ◊Ë¡„π‡∑»°“≈ Ala ‡æËÕ◊ §«“¡√°— „πæ√–‡®“â ·≈– »“ π“æ∑ÿ ∏ (2-20 ¡π’ “§¡) ®“°µ–«π— ¢πÈ÷ ®πµ–«π— µ°¥‘π ‡Àµÿº≈∑“ß®‘µ«≠‘ ≠“≥ »“ π“§√ ‘ µå ¢π÷È °∫— π‘°“¬  «à π„À≠Õà “®‡ªπì °“√ߥՓÀ“√∫“ßÕ¬“à ß ‡æ◊ÕË ‡ªìπ°“√Ωñ°Ωπµπ‡Õß„Àâ ·§∏Õ≈‘§ ¬ß—  “¡“√∂∫√‚‘ ¿§‡§√◊ÕË ß¥¡Ë◊ ∫“ß™π‘¥‰¥â  ”√«¡·≈–≈¥≈–°‡‘ ≈  »“ π“§√ ‘ µå Õ ’ ‡∑Õ√πå 𬑠¡ªØ∫‘ µ— ‘„πÀ¡àŸπ—°∫«™π°‘ “¬¡À“¬“π·≈–«™√‘ –¬“π ÕÕ√å‚∏¥Õ°´å ·µ‡à ¥‘¡§√‘ µ»“ π°‘ ™π·§∏Õ≈§‘ ߥ∫√‚‘ ¿§‡π◊ÈÕ µ— «å ‡æ◊ÕË ‡ªìπ°“√√”≈°÷ ∂÷ß°“√ „π«π— Ash Wednesday ·≈– Good Friday ‡ ’¬ ≈–¢Õßæ√–‡¬´§Ÿ √ ‘ µå ª®í ®∫ÿ π— „π«—π¥ß— °≈“à « ∫√‘‚¿§¡Õ◊È Õ“À“√ª°µ‘ 1 ¡È◊Õ ·≈–¡È◊Õ‡≈°Á Ê Õ°’ ‡æ¬’ ß 2 ¡◊ÈÕ ß¥°“√∫√‚‘ ¿§‡πÕ◊È  —µ«å ‰¢à ·≈–º≈‘µ¿—≥±å®“°π¡ ‡™ÕË◊ °—π«“à °“√ªØ∫‘ µ— ‘‡™àππÈ’ „πÀ≈“¬‡∑»°“≈  à«πª≈“ “¡“√∂∫√‚‘ ¿§‰¥‡â ªπì ™à«¬≈¥≈– §«“¡≈–‚¡¿ ∫“ß«—π µ–°≈– ·≈–𔉪 ¥àŸ π‘ ·¥π ¢Õßæ√–‡®â“ °“√»°÷ …“‡°¬Ë’ «°∫— º≈¢Õß°“√Õ¥Õ“À“√·≈–°“√®”°—¥·§≈Õ√’∑‡Ë’ ªπì «∑‘ ¬“»“ µ√å ¡°’ “√ µ’æ‘¡æ凪ìπ§√È—ß·√°„π«“√ “√‚¿™π“°“√ ‡¡Ë◊Õªï §.».19351 „π∫∑§«“¡π’È ºâŸ‡¢’¬π‰¥â· ¥ßº≈ °“√∑¥≈Õß∑Ë’™’È«à“ ÀπŸ∑¥≈Õß∑’ˉ¥â√—∫Õ“À“√·≈–¡’„¬Õ“À“√∑Ë’¬àÕ¬‰¡à‰¥âπ—Èπ “¡“√∂¡’Õ“¬ÿ‡©≈’ˬ·≈– Õ“¬ÿ¬“«π“π∑’Ë ÿ¥¡“°°«à“ÀπŸ∑Ë’‰¥â√—∫Õ“À“√ª°µ‘ µàÕ¡“‰¥â¡’°“√»÷°…“„π∑”πÕßπ’ÈÕ’°¡“°¡“¬ ≈â«π·µà„Àâº≈°“√∑¥≈Õß∑’˧≈⓬§≈÷ß°—π ´÷Ëß°“√»÷°…“¥—ß°≈à“«¬—߉¥â∑”„π —µ«å™π‘¥Õ◊ËπÊ ‡™àπ ÀπŸ ∂’∫®—°√ 2 ·¡≈ߺ≈‰¡â 3 ‰ â‡¥◊Õπ4 ‰√π”È ·¡ß¡ÿ¡·≈–ª≈“ 2 „π°“√»°÷ …“‚¥¬≈–‡Õ’¬¥¬ß— ‰¥æâ ∫«à“ Àπ∑Ÿ ¥≈Õß ∑Ë’‰¥√â ∫— Õ“À“√∑¡’Ë ·’ §≈Õ√®’ ”°¥— ¡§’ «“¡ª√“¥‡ª√¬’ «¡“°°«“à ¡’‰¢¡π— πÕâ ¬°«“à ·≈–¡Õ’ «¬— «– ¿“¬„π¢π“¥‡≈Á°°«à“ÀπŸ∑’ˉ¥â√—∫Õ“À“√ª°µ‘‡µÁ¡∑Ë’ 5 §«“¡ª√“¥‡ª√’¬««àÕ߉«πÈ’Õ“®‡πË◊Õß¡“®“° §«“¡µÕâ ß°“√Õ“À“√‡æ¡‘Ë ´Ëß÷ ‡ªìπ°“√µÕ∫ πÕß‚¥¬∏√√¡™“µ‘ 6 ‡æË◊Õ§«“¡‡¢â“„®°√–∫«π°“√∑Ë’‡°‘¥¢È÷π„π√à“ß°“¬‡¡◊ËÕ¡’°“√Õ¥Õ“À“√·≈–°“√®”°—¥ ·§≈Õ√’ ®”‡ªπì µÕâ ß∑√“∫∂ß÷ §«“¡À¡“¬¢Õß»æ— ∑Õå π— ®”‡ªπì ∑‡’Ë °¬Ë’ «¢Õâ ß Õπ— ‰¥·â °à Àπ«à ¬¢Õßæ≈ß— ß“π  “√Õ“À“√∑’Ë„Àæâ ≈—ßß“π ·≈–ª®í ®¬— ∑ˇ’ °Ë’¬«¢âÕß°∫— °“√‡ª≈’ˬπ·ª≈ß “√Õ“À“√‡À≈“à π’È °Õß°“√·æ∑¬å∑“߇≈Õ◊ ° °√¡æ—≤π“°“√·æ∑¬·å ºπ‰∑¬·≈–°“√·æ∑¬∑å “ß‡≈◊Õ°

∫∑∑’Ë 11 567 °“√Õ¥Õ“À“√·≈–°“√®”°¥— ·§≈Õ√’ æ≈—ßß“π·≈–Àπ«à ¬¢Õßæ≈ß— ß“π æ≈—ßß“π À¡“¬∂÷ß ‘Ëß∑Ë’„™â‡æË◊Õ°“√‡ª≈’ˬπ·ª≈ß∑“ß°“¬¿“æ À√◊Õ∑”„Àâ¡’°“√‡§≈Ë◊Õπ∑’Ë ¢Õß¡«≈ “√®“° ¿“æÀπË÷߉ª ŸàÕ’° ¿“æÀπ÷Ëß  Ë‘ß¡’™’«‘µ∑ÿ°™π‘¥≈â«πµâÕß„™âæ≈—ßß“π‡æË◊Õ°“√¥”√ß ™’«‘µ·≈–∑”°®‘ °√√¡µà“ßÊ ·§≈Õ√’ ‡ªìπÀπ૬¢Õßæ≈—ßß“π„π√–∫∫Àπ૬ “°≈ (SI units À√◊Õ Systeme Internationale dûUnites) À¡“¬∂÷ߪ√¡‘ “≥§«“¡√Õâ π∑’Ë∑”„Àâπ”È 1 °√—¡ ¡Õ’ ≥ÿ À¿Ÿ¡‘‡æ‘Ë¡¢÷Èπ®“° 14.5 Õß»“‡´≈‡´’¬  ‡ªìπ 15.5 Õß»“‡´≈‡´’¬  §”«à“ ·§≈Õ√’ ¥—ß°≈à“« ‡¢’¬π‡ªìπ¿“…“Õ—ß°ƒ…«à“ calorie ·µà·§≈Õ√’„π∑“ß‚¿™π“°“√ À¡“¬∂÷ß °‘‚≈·§≈Õ√’ (kilocalories) ·≈–π‘¬¡‡¢’¬π‡ªìπ ¿“…“Õß— °ƒ…«à“ Calorie ‚¥¬„™â C µ—«„À≠‡à æ◊ÕË „À·â µ°µ“à ß®“°·§≈Õ√∑’ «—Ë ‰ª ‚¥¬∑Ë—«‰ª πÈ”Àπ—°µ—«·≈–°‘®°√√¡µà“ßÊ ¢Õß¡πÿ…¬å¡’§«“¡ —¡æ—π∏åÕ¬à“߬‘Ëß°—∫ æ≈—ßß“π∑Ë’∫√‘‚¿§ °“√πÕπÀ≈—∫ °“√¥Ÿ‚∑√∑—»πå °“√‡¥‘π ·≈–°“√«Ë‘ß ≈â«πµâÕß°“√æ≈—ßß“π µà“ß°—π °≈à“«§◊Õ ®“°πâÕ¬‰ª¡“°µ“¡≈”¥—∫ ·≈–„π°‘®°√√¡Õ¬à“߇¥’¬«°—π ºŸâ∑Ë’¡’π”È Àπ—°µ—«¡“° °Á¬àÕ¡µâÕß°“√æ≈—ßß“π„π°“√∑”°‘®°√√¡π—ÈπÊ ¡“°°«à“¥â«¬ „π·µà≈–«—π√à“ß°“¬µâÕß„™âæ≈—ßß“π ®“°Õµ— √“‡¡µ–∫Õ≈°‘ æπ◊È ∞“π (resting metabolic rate) ‡™πà °“√À“¬„® °“√‡µπâ ¢ÕßÀ«— „® °“√√°— …“ Õÿ≥À¿Ÿ¡‘√à“ß°“¬ œ≈œ ª√–¡“≥√âÕ¬≈– 60-70 ¢Õßæ≈—ßß“π∑’Ë∫√‘‚¿§ ·≈–„™âÕ’°ª√–¡“≥ √âÕ¬≈– 10 ‡æË◊Õ°“√¬àÕ¬ °“√¥Ÿ¥´÷¡ ·≈–°“√‡ª≈’ˬπ·ª≈ß “√Õ“À“√ æ≈—ßß“π∑Ë’‡À≈◊Õª√–¡“≥ √Õâ ¬≈– 15-30 ®÷ß„™â‰ª„π°®‘ °√√¡ÕËπ◊ Ê  “√Õ“À“√∑Ë’„Àâæ≈ß— ß“π  “√Õ“À“√„Àâæ≈—ßß“π∑Ë’ ”§—≠ ‰¥â·°à §“√å‚∫‰Œ‡¥√µ ‰¢¡—π ·≈–‚ª√µ’π ”À√—∫ §“√å‚∫‰Œ‡¥√µππ—È ‡ªπì  “√Õ“À“√®”æ«°·ªßÑ ·≈–πÈ”µ“≈ ‰¥·â °à πÈ”µ“≈‡™ß‘ ‡¥¬Ë’ « (monosaccharide) ´÷Ëß¡’πÈ”µ“≈™π‘¥‡¥’¬«Àπ÷Ëß‚¡‡≈°ÿ≈ ‰¥â·°à °≈Ÿ‚§  ø√ÿ§‚µ  ·¡π‚π  ·°·≈§‚µ  π”È µ“≈‡™‘ß§àŸ (disaccharide) ´ß÷Ë ¡π’ È”µ“≈ Õß™π‘¥„πÀπßË÷ ‚¡‡≈°ÿ≈ ‡™πà ´Ÿ‚§√  ·≈§‚µ  ·≈– ¡“≈‚µ   à«π æ«°·ªÑß (starch À√◊Õ polysaccharide) ‡ªì𠓬‚´à∑Ë’¡’π”È µ“≈‡™‘߇¥Ë’¬«À≈“¬‚¡‡≈°ÿ≈¡“µàÕ°—π ∑È—ß·ªÑß·≈–πÈ”µ“≈‡™‘ß§àŸ µâÕß∂Ÿ°¬àÕ¬‚¥¬‡Õπ‰´¡å„π≈”‰ â®π‰¥â‡ªìππÈ”µ“≈‡™‘߇¥Ë’¬« °àÕπ∑’Ë®–  “¡“√∂∂°Ÿ ¥¥Ÿ ´÷¡‡¢â“ àŸ°√–· ‚≈Àµ‘ ‡æËÕ◊ „Àâ√à“ß°“¬π”‰ª„™â‰¥â ‡´≈≈‚Ÿ ≈  ®¥— ‡ªì𠓬‚´à¢Õßπ”È µ“≈°≈‚Ÿ §  ·µà‡Õπ‰´¡å¢Õß¡π…ÿ ¬å‰¡ à “¡“√∂µ¥— æπ— ∏– ∑Ë’‡™Ë◊Õ¡√–À«à“ß‚¡‡≈°ÿ≈¢Õßπ”È µ“≈°≈Ÿ‚§ ‡À≈à“π’ȉ¥â ¥—ßπÈ—π ‡´≈≈Ÿ‚≈ ®÷ß®—¥‡ªìπ„¬Õ“À“√∑Ë’¡πÿ…¬å ‰¡ à “¡“√∂¬Õà ¬‰¥â °Õß°“√·æ∑¬∑å “ß‡≈Õ◊ ° °√¡æ≤— π“°“√·æ∑¬å·ºπ‰∑¬·≈–°“√·æ∑¬∑å “ß‡≈◊Õ°

568 µ”√“«™‘ “°“√ Õ“À“√‡æË◊Õ ¢ÿ ¿“æ  “√Õ“À“√®”æ«°·ªÑß æ∫‰¥â¡“°¿“¬„π‡´≈≈å¢Õßæ◊™Õ“À“√ °“√ª√ÿßÕ“À“√„Àâ ÿ° ‚¥¬‡©æ“–Õ¬à“߬ˑ߇¡Ë◊Õ¡’πÈ”À√◊Õ‰Õπ”È √à«¡¥â«¬ ∑”„À⇰‘¥°“√©’°¢“¥¢Õߺπ—߇´≈≈å ·≈–∑”„Àâ Õ“À“√πÈ—π∂Ÿ°¬Õà ¬‰¥ßâ “à ¬¢Èπ÷ ·ªßÑ ®“°æ™◊ ∫“ß™π‘¥ (√âÕ¬≈– 20 ¢Õß∂Ë«— ‡¡≈¥Á ·Àßâ ·≈–√âÕ¬≈– 7-10 ¢Õߧ“√å‚∫‰Œ‡¥√µ®“°¢â“« “≈’ ¢â“«‚Õäµ ·≈–¡—πΩ√Ë—ß) ¡’§«“¡∑πµàÕ°“√¬àÕ¬¢Õ߇Õπ‰´¡å ¥—ßπÈ—π ®÷ß “¡“√∂ºà“π‰ª àŸ≈”‰ â„À≠à ´÷Ëß·ªÑ߇À≈à“π’È®–∂Ÿ°·ª√ ¿“æ‚¥¬°“√À¡—°®“°·∫§∑’‡√’¬„À⇪ìπ °√¥‰¢¡π— §“√å∫Õπ‰¥ÕÕ°‰´¥å·≈–·°´ä ¡‡’ ∑π πÈ”µ“≈°≈Ÿ‚§  ®—¥‡ªìπÀπ૬æ≈—ßß“πæ◊Èπ∞“π¢Õߧ“√å‚∫‰Œ‡¥√µ °≈Ÿ‚§ ®–√«¡°—∫ ÕÕ°´‘‡®π‡°‘¥‡ªìππÈ” §“√å∫Õπ‰¥ÕÕ°‰´¥å ·≈–æ≈—ßß“π ¢È—πµÕπ·√°¢Õß°√–∫«π°“√‡º“º≈“≠ °≈Ÿ‚§ ‡√’¬°«à“ ‰°≈‚§‰≈´‘  (glycolysis) ´÷Ëß‚¡‡≈°ÿ≈¢Õß°≈Ÿ‚§ Õ—πª√–°Õ∫¥â«¬§“√å∫Õπ 6 Õ–µÕ¡ ‡ª≈’ˬπ‡ªπì 2 ‚¡‡≈°≈ÿ ¢Õ߉æ√Ÿ‡«∑ ´ßË÷ ·µà≈–‚¡‡≈°ÿ≈ª√–°Õ∫‰ª¥«â ¬ §“√∫å Õπ 3 Õ–µÕ¡ ·≈–‡°‘¥ ATP ∑Ë’¡’æ≈—ßß“π Ÿß 2 ‚¡‡≈°ÿ≈ „π¢È—πµÕππ’Ȭ—߉¡à¡’°“√„™âÕÕ°´‘‡®π  ”À√—∫πÈ”µ“≈ ø√ÿ§‚µ  ·¡π‚π  ·≈–·°·≈§‚µ ∂Ÿ°‡ª≈Ë’¬π„ÀâÕ¬Ÿà„π√Ÿª¢Õß°≈Ÿ‚§ ∑Ë’µ—∫ °àÕπ®–‡ª≈’ˬπ‡ªìπ ‰æ√Ÿ‡«∑ ∂—¥®“°¢È—πµÕππÈ’ ‡¡◊ËÕ¡’ÕÕ°´‘‡®π ‰æ√Ÿ‡«∑®–∂Ÿ°‡ª≈Ë’¬π‡ªìπ§“√å∫Õπ‰¥ÕÕ°‰´¥å·≈– πȔլ“à ß ¡∫√Ÿ ≥å‚¥¬ citric acid cycle ´÷ßË ‡ªπì °√–∫«π°“√ ≈“¬°≈‚Ÿ § ·∫∫„™Õâ Õ°´‡‘ ®π (aero- bic glycolysis) °“√‡°‘¥‰æ√Ÿ‡«∑π—ÈπÕ¬àŸπÕ°‰¡‚µ§Õπ‡¥√’¬ „π¢≥–∑Ë’ citric acid cycle π—Èπ ‡°¥‘ ¢π÷È ¿“¬„π‰¡‚µ§Õπ‡¥√¬’ ‚¥¬°√–∫«π°“√∑‡Ë’ √¬’ °«“à oxidative phosphorylation °Õà π‡¢“â  Ÿà citric acid cycle ‰æ√‡Ÿ «∑∑’Ë¡’§“√å∫Õπ 3 Õ–µÕ¡  ≠Ÿ ‡ ¬’ §“√å∫Õπ‰ª 1 Õ–µÕ¡ „πªØ‘°‘√¬‘ “∑’Ë„Àâæ≈—ßß“π ·≈–§“√å∫Õπ‰¥ÕÕ°‰´¥å °≈àÿ¡Õ–‡´∑‘≈∑Ë’¡’§“√å∫Õπ 2 Õ–µÕ¡∑Ë’‡À≈◊Õ°Á√«¡°—∫ Coenzyme A ‡°¥‘ ‡ªπì acetyl CoA ´ß÷Ë ®–‡¢â“ Ÿà citric acid cycle ‡æ◊ËÕ‡ª≈’ˬπ‡ªπì π”È ·≈–§“√∫å Õπ‰¥ÕÕ°‰´¥å „π ¿“«–∑Ë’‰¡à¡’ÕÕ°´‘‡®π ‰æ√Ÿ‡«∑®–∂Ÿ°‡ª≈’ˬπ‡ªìπ·≈§‡µ∑‚¥¬°√–∫«π°“√ ≈“¬ °≈Ÿ‚§ ·∫∫‰¡à„™âÕÕ°´‡‘ ®π (anerobic glycolysis) ´Ëß÷  “¡“√∂„Àâæ≈ß— ß“π„π√Ÿª¢Õß‚¡‡≈°ÿ≈ ATP ¡“°°«à“°√–∫«π°“√∑’Ë„™âÕÕ°´‘‡®π∂÷ß 19 ‡∑à“ °√–∫«π°“√¥—ß°≈à“«®”‡ªìπ ”À√—∫°“√∑”ß“π ¢Õß°≈â“¡‡πÕ◊È ´÷ßË µâÕß„™æâ ≈ß— ß“πª√¡‘ “≥¡“°„π‡«≈“Õπ— ®”°¥— ∑Ë’‰¡à¡’ÕÕ°´‘‡®π·≈°‡ª≈¬Ë’ π‡æ¬’ ßæÕ ‡™πà æ≈ß— ß“π∑’Ë„™â„π°“√«‘Ëß√–¬– 100 ‡¡µ√ „π 10 «π‘ “∑’ ‡ªìπ·∫∫‰¡à„™âÕÕ°´‡‘ ®π∂÷ß√âÕ¬≈– 85 ¢≥–∑Ë’æ≈—ßß“π∑Ë’„™â„π°“√«‘Ëß√–¬–∑“߉°≈ 60 π“∑’°≈—∫‡ªìπ·∫∫„™âÕÕ°´‘‡®π√âÕ¬≈– 95 §“√å‚∫‰Œ‡¥√µ∂°Ÿ  – ¡„π√“à ß°“¬„π√ªŸ ·∫∫¢Õß glucose polymer ∑‡’Ë √’¬°«à“ glycogen „π§π ∑Ë’Àπ—° 70 °‘‚≈°√—¡¡’ glycogen  – ¡∑’˵—∫ª√–¡“≥ 100 °√—¡ ·≈–∑Ë’°≈â“¡‡πÈ◊ÕÕ’°ª√–¡“≥ 400 °√—¡ ´Ë÷ß√«¡·≈⫉¥âæ≈—ßß“πª√–¡“≥ 2,000 ·§≈Õ√’Ë „π∑“ß°≈—∫°—π ™“¬§ππ’ÈÕ“®¡’ æ≈—ßß“π – ¡‡æ‘Ë¡‡ªìπ 50 ‡∑à“„π√Ÿª¢Õ߉¢¡—π ‚¥¬ª°µ‘ª√–¡“≥§√Ë÷ßÀπË÷ߢÕß°≈Ÿ‚§ ∑’Ë∫√‘‚¿§ ∂Ÿ°ÕÕ°´‘‰¥´å‡ªìπ§“√å∫Õπ‰¥ÕÕ°‰´¥å·≈–π”È √âÕ¬≈– 30-40 ‡ª≈Ë’¬π‡ªìπ‰¢¡—π ·≈–ª√–¡“≥ °Õß°“√·æ∑¬∑å “ß‡≈Õ◊ ° °√¡æ—≤π“°“√·æ∑¬·å ºπ‰∑¬·≈–°“√·æ∑¬∑å “ß‡≈Õ◊ °

∫∑∑’Ë 11 569 °“√Õ¥Õ“À“√·≈–°“√®”°—¥·§≈Õ√’ √Õâ ¬≈– 5 ∂Ÿ° – ¡„π√Ÿª¢Õß glycogen §“√å‚∫‰Œ‡¥√µ®“°Õ“À“√≈¥√–¥—∫¢Õß HDL cholesterol „π´’√—Ë¡ ·≈–π”È µ“≈´Ÿ‚§√ ¬Ë‘ß≈¥√–¥—∫ HDL ¡“°¬ßË‘ ‰ª°«à“°≈Ÿ‚§  ‰¢¡—π∑’Ë∫√‘‚¿§‰¥â (dietary fat) ª√–°Õ∫‰ª¥â«¬ ‰µ√°≈’‡´Õ‰√¥å (triglycerides) ‡ªìπ  «à π„À≠à ·≈–¬ß— Õ“®¡ ’ “√æ«°øÕ øÕ‰≈ª¥î  å (phospholipids) ‡™πà lecithin ·≈– sphingolipids À√◊Õ sterol ‡™àπ cholesterol Õ¬∫Ÿà “â ß ‰µ√°≈’‡´Õ‰√¥ªå √–°Õ∫‰ª¥â«¬ glycerol ÀπËß÷ ‚¡‡≈°≈ÿ ‡°“– °—∫°√¥‰¢¡—π 3 ‚¡‡≈°ÿ≈ °√¥‰¢¡—π∑’ËÕ¬àŸ„πÕ“À“√¡—°¡’ “¬‚´à∑Ë’ª√–°Õ∫¥â«¬ carbpon atom 16-18 µ—« ¬°‡«âπ‰¢¡—π®“°π¡ πÈ”¡—π¡–æ√â“«À√◊ÕπÈ”¡—πª“≈å¡ ´÷Ëß¡’‰¢¡—𠓬‚´à —Èπ„π —¥ à«π ∑’Ë¡“° °√¥‰¢¡π— ∑Ë’¡’ carbon atom „𠓬‚´àπÕâ ¬°«“à 14 µ—«®–®—∫°—∫‚ª√µ’π albumin ·≈–∂Ÿ° π”擉ª¬—ßµ—∫ ´÷Ë߉¢¡—π‡À≈à“πÈ’®–‰¡à∂Ÿ° – ¡ phospholipids, cholesterol ·≈– long-chain triglyceride ∂°Ÿ ¢π àß®“°‡¬ÕË◊ ∫≈ÿ ”‰ ‡â ≈Á°„π√ªŸ ¢Õß chilomicrons «µ‘ “¡π‘ ·≈–‚ª√«‘µ“¡π‘ ∑’Ë≈–≈“¬ „π‰¢¡π— Õ—π‰¥â·°à beta-carotene, «‘µ“¡π‘ A, D, E ·≈– K √«¡∑—Èß°√¥ lenolenic, lenoleic ·≈– arachidonic ´ß÷Ë ‡ªìπ “√Õ“À“√∑Ë’®”‡ªìπ°∂Á °Ÿ ¥¥Ÿ ´¡÷ ‰ªæ√âÕ¡°∫— ‰¢¡—π™π‘¥ÕË◊πÊ ¥«â ¬ °√¥‰¢¡—π∑’Ë¡’„π∏√√¡™“µ‘¡’®”π«π§“√å∫ÕπÕ–µÕ¡‡ªìπ‡≈¢§àŸ °√¥‰¢¡—𠓬‚´à¬“« ∑Ë’Õ¬ŸàπÕ°‰¡‚µ§Õπ‡¥√’¬µâÕ߇™◊ËÕ¡°—∫ carnitine ´÷Ë߇ªìπÕπÿæ—π∏å¢Õß°√¥Õ–¡‘‚π lysine ‡æË◊Õºà“π ‡¡¡‡∫√π¢Õ߉¡‚µ§Õπ‡¥√’¬ ®“°πÈ—π ·µà≈–™à«ß∑Ë’¡’ 2 §“√å∫ÕπÕ–µÕ¡°Á·¬°ÕÕ°‡æ◊ËÕ√«¡°—∫ Coenzyme A ‡°‘¥‡ªπì acetyl-CoA ´Ë÷ß®–‡¢“â  àŸ citric acid cycle °“√ —߇§√“–À°å √¥∑—ÈßÀ¡¥ ‡°‘¥¢÷Èπ„π‰¡‚§√‚´¡ ´Ë÷ßÕ¬ŸàπÕ°‰¡‚µ§Õπ‡¥√’¬ ‡√‘Ë¡®“° acetyl-CoA √«¡°—∫ glycerol ‡ªìπ triglyceride ‚¥¬æ◊πÈ ∞“π·≈â«°“√ ß— ‡§√“–Àå°√¥‰¢¡π— ‡°‘¥∑’˵—∫ ·µ°à ¡Á ’∫“â ß∑‡’Ë π◊ÈÕ‡¬Ë◊Õ‰¢¡π— ‰¢¡—π∑’Ë  – ¡∑È—ßÀ¡¥¡“®“°‰¢¡—π®“°Õ“À“√ √“«√âÕ¬≈– 23 ¢Õßæ≈—ßß“π®“°§“√å‚∫‰Œ‡¥√µ‡ ’¬‰ª„π °√–∫«π°“√‡ª≈Ë’¬π‡ªìπ‰¢¡—π – ¡ ¢≥–∑’ˇ撬ß√âÕ¬≈– 2 ¢Õßæ≈—ßß“π®“°Õ“À“√‰¢¡—π‡∑à“πÈ—π ∑Ë’„™â ‰ª„π°“√ – ¡‰¢¡π— ‚ª√µ’𠇪ì𠓬‚´à¢Õß°√¥Õ–¡‘‚π ´Ë÷߇¡Ë◊Õ∫√‘‚¿§‡¢â“ àŸ√à“ß°“¬·≈â«®–∂Ÿ°¬àÕ¬¥â«¬ ‡Õπ‰´¡å„À⇪ìπ°√¥Õ–¡‘‚πÕ‘ √– ·≈–∂Ÿ°¥Ÿ¥´÷¡‡¢â“ àŸ°√–· ‚≈À‘µ‰ª¬—ßµ—∫‡ªìπÕ—π¥—∫·√° ≥ ∑’ËπÈ’ °√¥Õ–¡‘‚π®–∂Ÿ° ≈“¬ µ—«Õ¬à“߇™πà ‚ª√µ’π®“°‡πÈ◊Õ —µ«ªå √–°Õ∫¥«â ¬°√¥Õ–¡‚‘ π·∫∫ “¬‚´·à ¬° (branch-chain) √“«√Õâ ¬≈– 20 ·µ°à √¥Õ–¡‚‘ π∑Õ’Ë Õ°®“°µ∫— °≈∫— ‡ªπì ·∫∫ “¬‚´·à ¬°∂ß÷ √Õâ ¬≈– 70 §«“¡ —¡æ—π∏å¢Õßæ◊Èπ∞“π¢Õß°√¥Õ–¡‘‚π„πÕ“À“√¡πÿ…¬å§◊Õ‡ªìπÀπ૬¬àÕ¬ ”À√—∫ —߇§√“–Àå ‚ª√µπ’ ·≈–‡Õπ‰´¡å ‚¥¬‡©æ“–Õ¬“à ߬ßË‘ „π∑“√°·≈–‡¥°Á ´Ëß÷ µâÕß°“√°√¥Õ–¡‘‚π∑Ë’®”‡ªìπ´Ë÷ß√à“ß°“¬  ß— ‡§√“–Àå‰¡à‰¥â„π ¥—  «à π∑¡Ë’ “°°«“à ºâŸ„À≠à °√¥Õ–¡‚‘ π∑®Ë’ ”‡ªπì  ”À√∫— ¡π…ÿ ¬ºå Ÿâ„À≠§à Õ◊ isoleucine, leucine, lysine, methionine, phenylalanine, theonine, tryptophan ·≈– valine  ”À√—∫∑“√° ¬ß— µâÕß°“√ histidine ·≈–„π µ— «å™π¥‘ ÕË◊πÊ „𫬗 ‡¬“«¬å —ßµâÕß°“√ arginine Õ’°¥â«¬ “√ purine ·≈–pyrimidine ´ß÷Ë ‡ªπì  à«πª√–°Õ∫∑’Ë®”‡ªπì ¢Õß DNA ·≈– RNA  ß— ‡§√“–À¡å “®“°°√¥Õ–¡‚‘ π „πµ∫— °Õß°“√·æ∑¬∑å “ß‡≈◊Õ° °√¡æ≤— π“°“√·æ∑¬å·ºπ‰∑¬·≈–°“√·æ∑¬å∑“߇≈◊Õ°

570 µ”√“«™‘ “°“√ Õ“À“√‡æ◊ËÕ ¢ÿ ¿“æ °√¥Õ–¡‘‚π alanine, glycine, serine ·≈– threonine  “¡“√∂‡ª≈¬Ë’ π‡ªπì pyruvate ·≈–°≈Ÿ‚§  „π≈”¥—∫µàÕ¡“‰¥â °√–∫«π°“√ —߇§√“–Àå°≈Ÿ‚§ ®“° “√∑Ë’‰¡à„™à§“√å‚∫‰Œ‡¥√µπÈ’ ‡√’¬°«à“ gluconeogenesis ‡Õπ‰´¡å∑Ë’„™â„π°“√°≈—∫∑‘»∑“ߢÕß glycolysis ( √â“ß°≈Ÿ‚§ ®“° pyruvate) æ∫‰¥â„πµ∫— ·≈–‰µ ·≈–∑Ë’π‡’Ë Õß∑‡’Ë °‘¥°√–∫«π°“√ gluconeogenesis °√¥Õ–¡‚‘ πÕË◊πÊ  “¡“√∂„Àâæ≈—ßß“π‰¥â‚¥¬°“√‡¢â“‰ª„π citric acid cycle ≥ ®ÿ¥µà“ßÊ °—π À√◊Õ∂Ÿ°¬àÕ¬ ≈“¬ ‡ªìπ°√¥ glutamic ´÷Ëß “¡“√∂‡¢â“ àŸ citric acid cycle ‰¥â ·¡â«à“°≈Ÿ‚§  “¡“√∂‡ª≈Ë’¬π‡ªìπ ‰¢¡π— ‰¥â (‚¥¬ºà“π acetyl-CoA) ·µà‚¥¬ «à π„À≠·à ≈«â ‰¢¡—π‰¡à “¡“√∂‡ª≈¬Ë’ π‡ªπì °≈‚Ÿ § ‰¥â  ¡Õß µÕâ ß°“√ “√Õ“À“√∑≈’Ë –≈“¬π”È ‰¥â ·≈–‰¡ à “¡“√∂ √“â ß°≈‚Ÿ § ®“°°√–∫«π°“√ gluconeogenesis ¥—ßπ—Èπ°≈Ÿ‚§ ®÷߇ªìπ·À≈àßæ≈—ßß“π¢Õß ¡Õß Õ«—¬«–ÕË◊πÊ ‚¥¬‡©æ“–Õ¬à“߬‘ËßÀ—«„®®–ÕÕ°´‘‰¥´å °√¥‰¢¡π— Õ ‘ √–„π∞“π–æ≈ß— ß“πÕ°’ ·À≈ßà Àπß÷Ë °≈“â ¡‡πÕÈ◊ ≈“¬πÕ°®“°¡’ glycogen  – ¡‰«Õâ ¬·àŸ ≈«â ¬—ß – ¡æ≈—ßß“π„π√Ÿª¢Õß phosphocreatine Õ’°¥â«¬ °≈â“¡‡π◊ÈÕ≈“¬®–„™â°√¥Õ–¡‘‚π·∫∫¡’  “¬‚´à·¬° ‚¥¬‡©æ“–Õ¬“à ߬‘Ëß leucine ‡ªìπæ≈ß— ß“π°ÁµàÕ‡¡ÕË◊ glycogen ¡√’ –¥—∫µË” ŒÕ√å‚¡π·≈–°“√‡ª≈¬’Ë π·ª≈ߢÕß “√Õ“À“√ Õπ‘ ´≈Ÿ ‘π (insulin) ‡ªπì ŒÕ√å‚¡π∑˪’ √–°Õ∫‰ª¥«â ¬ polypeptide ¢Õß°√¥Õ–¡‘‚π 21 µ—« ‡™Ë◊Õ¡°—∫ polypeptide ¢Õß°√¥Õ–¡‘‚πÕ°’ 30 µ«— Õπ‘ ´≈Ÿ ‘π¢Õß¡π…ÿ ¬å¡’ half-life ª√–¡“≥ 5 π“∑’ (≈¥ª√‘¡“≥≈ߧ√÷ËßÀπ÷Ëß∑ÿ°Ê 5 π“∑’) Õ‘π´Ÿ≈‘πÀ≈Ë—ß¡“®“°µ—∫ÕàÕπ ‡¡◊ËÕ°≈Ÿ‚§ „π‡≈◊Õ¥¡’√–¥—∫ Ÿß ·¡â«“à °√¥Õ–¡‘‚π∫“ß™π¥‘ °√¥§’‚µ glucagon ŒÕ√å‚¡π®“°≈”‰ â acetylcholine ·≈–°“√°√–µÿâπ ª√– “∑ vagus  “¡“√∂°√–µâÿπ°“√À≈Ë—ßÕ‘π´Ÿ≈‘π‰¥â „π∑“ß°≈—∫°—π √–¥—∫Õ‘π´Ÿ≈‘π„π‡≈◊Õ¥∑’Ë Ÿß norepinephrine, epinephrine ·≈–°“√°√–µâÿπµ—∫ÕÕà π‚¥¬ sympathetic nerve  “¡“√∂¬∫— ¬Èß— °“√À≈Ë—ßÕ‘π´Ÿ≈‘π‰¥â Õ‘π´Ÿ≈‘π™à«¬„Àâ°≈Ÿ‚§ ‡¢â“ Ÿà‡´≈≈å¢Õß∑ÿ°Ê ‡π◊ÈÕ‡¬Ë◊Õ ¬°‡«âπ ¡Õß µ—∫ ·≈–µ—∫ÕàÕπ ‚¥¬ª°µ‘ Õ‘π´Ÿ≈‘π‡æ‘Ë¡°“√π”°≈Ÿ‚§ ‡¢â“ àŸ°≈â“¡‡πÈ◊Õ≈“¬¡“°°«à“ 3 ‡∑à“ ·µà°“√π”°≈Ÿ‚§ ‡¢â“ àŸ °≈â“¡‡πÈ◊Õ≈“¬°Á¬—߇æ‘Ë¡¢÷Èπ‰¥â „π¿“«–‰¡à „™âÕÕ°´‘‡®π¢Õß°“√ÕÕ°°”≈—ß°“¬‚¥¬‰¡à æ÷Ë ß Õ‘ π ´Ÿ ≈‘ π πÕ°‡Àπ◊Õ‰ª®“°™à«¬π”°≈Ÿ‚§ ‡¢â“ Ÿà‡´≈≈å·≈â« Õ‘π´Ÿ≈‘π¬—ß°√–µâÿπ°“√ —߇§√“–À傪√µ’π®“° °√¥Õ–¡‘‚π ‚¥¬‡©æ“–Õ¬à“߬ˑ߄π°≈â“¡‡πÈ◊Õ ·≈–¬—ß°√–µâÿπ°“√ —߇§√“–Àå·≈–°“√ – ¡‰¢¡—π ·≈–‡æË¡‘ °“√ —߇§√“–Àå glycogen Õ“°“√ßà«ßπÕπÀ≈—ß®“°¡◊ÈÕÕ“À“√∑Ë’¡’§“√å‚∫‰Œ‡¥√µ¡“° ‡ªìπµ—«™’È∂÷߃∑∏‘Ï¢ÕßÕ‘π´Ÿ≈‘π °≈‚Ÿ § ®“°§“√å‚∫‰Œ‡¥√µ°√–µπâÿ °“√À≈—ßË Õπ‘ ´Ÿ≈π‘ ´ßË÷ ∑”„À¡â °’ “√π”°√¥Õ–¡‚‘ π∑¡Ë’  ’ “¬‚´·à ¬°‡¢â“ àŸ °Õß°“√·æ∑¬å∑“߇≈◊Õ° °√¡æ—≤π“°“√·æ∑¬·å ºπ‰∑¬·≈–°“√·æ∑¬∑å “ß‡≈◊Õ°

∫∑∑’Ë 11 571 °“√Õ¥Õ“À“√·≈–°“√®”°¥— ·§≈Õ√’ ‡πÈÕ◊ ‡¬Õ◊Ë °≈â“¡‡πÈÕ◊ ¡“°¢π÷È  ¥—  «à π¢Õß°√¥Õ–¡‘‚π tryptophan „π‡≈Õ◊ ¥∑’Ë‡æ¡‘Ë ¢π÷È ∑”„Àâ °√¥Õ–¡‘‚π µ—«ÕË◊π·¢à߇¢â“ àŸ ¡Õ߉¥âπâÕ¬≈ß √–¥—∫¢Õß°√¥Õ–¡‘‚π tryptophan „π ¡Õß®÷߇æË‘¡¢÷Èπ·≈–‡°‘¥ °“√ —߇§√“–Àå serotonin ¡“°¢πÈ÷ ´ßË÷ serotonin π’‡È Õß∑”„À⇰‘¥Õ“°“√ß«à ßπÕπ °≈Ÿ§“°Õπ (glucagon) ‡ªìπ polypeptide ∑Ë’¡’°√¥Õ–¡‘‚π 29 µ—« ¡’ half-life „π °√–· ‚≈À‘µ ª√–¡“≥ 5-10 π“∑’ À≈—Ëß¡“®“°µ—∫ÕàÕπ‡¡Ë◊Õ√–¥—∫°≈Ÿ‚§ „π‡≈◊Õ¥µ”Ë ·≈–‚¥¬°“√ °√–µâÿπµ—∫ÕàÕπ‚¥¬µ√ß®“°ª√– “∑ sympathetic πÕ°®“°π’ÈÕ“À“√∑Ë’¡’‚ª√µ’π Ÿß ‚¥¬‡©æ“– Õ¬“à ߬‘ßË ∑¡Ë’ ’°√¥Õ–¡‚‘ π alanine, serine, glycine, cysteine, ·≈– threonine ∑ Ë’ “¡“√∂‡ª≈Ë’¬π ‡ªìπ°≈Ÿ‚§ ∑Ë’µ—∫¬—ß°√–µâÿπ°“√À≈Ë—ß glucagon ‰¥âÕ’°¥â«¬ glucagon ‰¡à‡æ’¬ß™à«¬ à߇ √‘¡ °√–∫«π°“√ gluconeogenesis ·µ¬à —ߙ૬¬àÕ¬ ≈“¬ glycogen ·≈–ª≈àÕ¬°√¥‰¢¡π— Õ‘ √– ·≈– glycerol ®“°‡πÕ◊È ‡¬◊ËÕ‰¢¡—π ª√–¡“≥√Õâ ¬≈– 60-70 ¢Õß°“√ √“â ß°≈‚Ÿ § ∑ˇ’ æË‘¡¢÷Èπ„π√–À«“à ß°“√ ÕÕ°°”≈—ß°“¬‡°‘¥¢÷Èπ‚¥¬ºà“π°“√À≈—Ëß glucagon ∑’ˇæË‘¡¢È÷πæ√âÕ¡Ê °—∫°“√¬—∫¬È—ß°“√À≈—ËßÕ‘π´Ÿ≈‘π ·≈–∑’ˇÀ≈Õ◊ Õ°’ √Õâ ¬≈– 30-40 ‡πÕË◊ ß¡“®“° epinephrine ŒÕ√å‚¡πÀ≈“¬™π‘¥ ‡™àπ epinephrine, thyroid hormones, prostaglandins, sex hormones, intestinal hormones ·≈–ŒÕ√å‚¡πÕ◊ËπÊ ≈â«π¡’º≈µàÕ°√–∫«π°“√‡¡µ–∫Õ≈‘ ¡å ¢Õß “√Õ“À“√µà“ßÊ Growth hormones ‡§≈Ë◊Õπ¬â“¬°√¥‰¢¡—πÕ‘ √–®“°‡πÈ◊Õ‡¬◊ËÕ‰¢¡—π·≈–™à«¬  à߇ √‘¡°“√π”°√¥Õ–¡‘‚π‡¢“â  Ÿ°à ≈â“¡‡πÈÕ◊ ‡æËÕ◊  —߇§√“–À傪√µ’π „π√–À«à“ß 2 ™Ë«— ‚¡ß·√°À≈ß— ®“° ‰¥√â —∫ growth hormones ‡ √‘¡ƒ∑∏Ï¢‘ ÕßÕπ‘ ´≈Ÿ π‘ ‚¥¬™«à ¬‡√ßà °“√À≈Ë—ßÕ‘π´Ÿ≈π‘ ·µàƒ∑∏Ï‘„π√–¬–¬“« °≈—∫‡ªìπ·∫∫µâ“πÕ‘π´Ÿ≈‘π ‡πË◊Õß®“°¡—π≈¥°“√π”°≈Ÿ‚§ ‡¢â“ Ÿà‡´≈≈å„π‡πÈ◊Õ‡¬Ë◊Õ∫“ß™π‘¥·≈–¬—∫¬—Èß glucose phosphorylation ´Ë÷߇ªπì ¢Èπ— µÕπ·√°¢Õß°√–∫«π°“√ ≈“¬°≈‚Ÿ §  °≈Ÿ‚§§Õ√嵑§Õ¬¥å (glucocorticoids) ‡ªì𠇵’¬√Õ¬¥å®“° adrenal cortex ¡’º≈ Õ¬à“ß°«â“ߢ«“ßµàÕ‡¡µ–∫Õ≈‘ ¡å¢Õß‚ª√µ’π·≈–§“√å‚∫‰Œ‡¥√µ glucocorticoids ∑Ë’¡’ƒ∑∏Ï‘·√ß∑’Ë ÿ¥ §Õ◊ cortisol µ“¡¥â«¬ cortisone, corticosterone ·≈– aldosterone  “√‡À≈“à π‡’È æ¡‘Ë °“√ ≈“¬ ‚ª√µ’π„π°≈â“¡‡π◊ÈÕ≈“¬ ‡æË‘¡°“√π”°√¥Õ–¡‘‚π‡¢â“ Ÿà‡´≈≈å∑’˵—∫¡“À≈Ë—ß°≈Ÿ‚§ ‡æË‘¡®“°µ—∫‡¢â“ Ÿà √–∫∫‰À≈‡«’¬π ‡æ‘Ë¡ª√‘¡“≥°√¥‰¢¡—πÕ‘ √–„πæ≈“ ¡“ ≈¥°“√ —߇§√“–À剢¡—π„πµ—∫ ·≈–‡æ‘Ë¡ ‰¢¡—π¢Õß√à“ß°“¬ º≈¢Õß°“√Õ¥Õ“À“√·≈–°“√®”°—¥·§≈Õ√µ’ àÕ°“√∑”ß“π¢Õß√“à ß°“¬ „π«—π·√°Ê ¢Õß°“√Õ¥Õ“À“√ æ∫«“à √–¥—∫¢ÕߌÕ√å‚¡πÕ‘π´≈Ÿ π‘ §Õà ¬Ê ≈¥≈ß„π¢≥–∑’Ë √–¥—∫¢Õß°≈Ÿ§“°Õπ§àÕ¬Ê ‡æË‘¡¢÷Èπ „π‰¡à™â“‰°≈‚§‡®π∑Ë’ – ¡‰«â°ÁÀ¡¥‰ª·≈–√–¥—∫¢Õß°≈Ÿ§“°Õπ °Á¢÷Èπ Ÿà√–¥—∫ Ÿß ÿ¥„π«—π∑’Ë “¡ ‡¡◊ËÕ°√–∫«π°“√ gluconeogenesis ¥”‡π‘π‰ªÕ¬à“߇µÁ¡∑’Ë °Õß°“√·æ∑¬∑å “ß‡≈◊Õ° °√¡æ—≤π“°“√·æ∑¬å·ºπ‰∑¬·≈–°“√·æ∑¬∑å “ß‡≈◊Õ°

572 µ”√“«™‘ “°“√ Õ“À“√‡æ◊ËÕ ¢ÿ ¿“æ ‡πÈ◊Õ‡¬Ë◊Õ°≈â“¡‡π◊ÈÕª≈àÕ¬°√¥Õ–¡‘‚π®”π«π¡“° ( à«π„À≠à‡ªìπ alanine ·≈– glutamine) √“««—π≈– 50 °√—¡ „π§π∑Ë’¡’πÈ”Àπ—°ª√–¡“≥ 70 °‘‚≈°√—¡ glutamine  à«π„À≠à∂Ÿ°‡ª≈’ˬπ‡ªìπ alanine ∑Ë’≈”‰ â ´Ë÷ß®–∂Ÿ°µ—∫‡ª≈’ˬπ‡ªìπ°≈Ÿ‚§ µàÕ‰ª „π√–À«à“ß°“√Õ¥Õ“À“√πÈ’ °√¥‰¢¡—πÕ‘ √– ∑—ÈßÀ¡¥„π°√–· ‚≈À‘µ‡°‘¥®“°°“√ ≈“¬ triglyceride „π adipose tissue ¡“°°«à“∑Ë’‡°‘¥ ®“°°“√ hydrolysis ¢Õß chylomicron ·≈– VLDL „π¿“«–∫√‚‘ ¿§Õ“À“√‡ªπì ª°µ‘ ‚¥¬∑—«Ë ‰ª °√¥‰¢¡—π ≈“¬‡ªπì acetyl-CoA ´ß÷Ë ‡¢â“ àŸ citric acid cycle ·µà‡¡ÕË◊ √“à ß°“¬‰¥â√∫— §“√å‚∫‰Œ‡¥√µ πÕâ ¬°«“à «π— ≈– 150-180 °√¡— °®Á –°¥°“√‡¢“â  àŸ  àŸ citric acid cycle ¢Õß acetyl-CoA ·≈–‡°¥‘ °“√ – ¡¢Õß acetoacetyl-CoA ´Ë÷ß®–∂Ÿ°µ—∫‡ª≈’ˬπ‡ªìπ ketone body acetoacetate ´Ë÷ß∑” ªØ‘°‘√‘¬“°—∫°√¥‡°‘¥‡ªìπ beta-hydroxybutyrate ·≈– acetone („π‡πÈ◊Õ‡¬Ë◊ÕÕË◊πÊ ¿“¬πÕ°µ—∫) ketone body ‡À≈à“π’È°≈“¬‡ªìπ·À≈àßæ≈—ßß“π∑’Ë ”§—≠ ”À√—∫°≈â“¡‡πÈ◊Õ¢≥–∑’Ë°≈â“¡‡πÈ◊ÕªÑÕπ °≈‚Ÿ § „Àâ°—∫ ¡Õß‚¥¬°“√ Ÿ≠‡ ’¬‚ª√µπ’ ‡¡◊ÕË °“√Õ¥Õ“À“√¥”‡π‘π‰ª‡°π‘ 3 «π—  ¡Õß° Á “¡“√∂ª√∫— µ—«‰ª„™â ketone body ‡ªπì ·À≈àßæ≈—ßß“π¡“°°«à“°≈Ÿ‚§  ª√– ‘∑∏‘¿“æ¢Õ߉µ„π°“√√—°…“ ketone body ‡æË‘¡¡“°¢È÷π °≈â“¡‡π◊ÈÕ‡√Ë‘¡„™â°√¥‰¢¡—πÕ‘ √–‡ªìπ·À≈àßæ≈—ßß“π¡“°¢È÷π·∑π∑Ë’ ketone body ·≈–°“√ Ÿ≠‡ ’¬ ‚ª√µπ’ ¢Õß°≈â“¡‡π◊ÕÈ °Á≈¥≈ßÕ¬à“߇ÀÁπ‰¥â™¥— ‡™πà ‡¥’¬«°∫— °“√‡°¥‘ gluconeogenesis „πµ∫— „π —µ«å‡≈È’¬ß≈Ÿ°¥â«¬π¡ ¡’°≈‰°æÈ◊π∞“π ÕßÕ¬à“ß∑’˧«∫§ÿ¡°“√∫√‘‚¿§Õ“À“√ °≈à“«§◊Õ °≈‰°√–¬– È—π·≈–°≈‰°√–¬–¬“« °≈‰°√–¬– —ÈπÀ√◊Õ§«“¡À‘«·∫∫ªí®®ÿ∫—π∑—π¥à«π®–§«∫§ÿ¡ °“√∫√‘‚¿§Õ“À“√„π·µà≈–«—π „π§πª°µ‘¥Ÿ‡À¡◊Õπ«à“√–¥—∫¢Õß°≈Ÿ‚§ „π‡≈◊Õ¥®–‡ªìπµ—«§«∫§ÿ¡ §«“¡Õ¬“°Õ“À“√¡“°°«“à §«“¡Õ¡‘Ë ∑°’Ë √–‡æ“–Õ“À“√ ·µà„π§π∑¡’Ë ¿’ “«–‡∫“À«“πÕ“®¡√’ –¥∫— °≈‚Ÿ §  „π‡≈◊Õ¥∑’Ë Ÿß„π¢≥–∑Ë’¬—ßµâÕß°“√∫√‘‚¿§Õ“À“√À√◊Õ·§≈Õ√’Ë ‡πË◊Õß®“°°“√¢“¥Õ‘π´Ÿ≈‘π ∑”„À⇴≈≈å ‰¡à “¡“√∂„™â°≈Ÿ‚§ ‰¥â ¥—ßπ—È𧫓¡µà“ß√–À«à“ß√–¥—∫¢Õß°≈Ÿ‚§ „πÀ≈Õ¥‡≈◊Õ¥·¥ß·≈– À≈Õ¥‡≈◊Õ¥¥” ®÷߇ªìπ¥—™π’«—¥§«“¡À‘«‰¥â‡ªìπÕ¬à“ߥ’ πÕ°®“°πÈ—π ¬—ß¡’ —≠≠“≥‚¥¬µ√ß®“° ≈”‰ â‡≈Á° à«πµâπ (duodenum) ∑Ë’ à߉ª¬—ß»Ÿπ¬å§«∫§ÿ¡§«“¡À‘«·≈–§«“¡Õ‘Ë¡„π hypothalamus ‡æËÕ◊ °¥ À√Õ◊ ‡æ¡‘Ë activity „π°“√µÕ∫ πÕßµàÕª√¡‘ “≥¢ÕßÕ“À“√∑Ë’Õ¬Ÿà„π≈”‰ â  ”À√—∫°≈‰°√–¬–¬“« ‡ªìπ°“√®—¥ ¡¥ÿ≈¢Õß°√–∫«π°“√µà“ßÊ ∑’Ë∑”„Àâ√à“ß°“¬¡’ ™’«‘µÕ¬Ÿà‰¥âÕ¬à“߇À¡“– ¡ ∑Ë’ ”§—≠§◊Õ°“√√—°…“πÈ”Àπ—°¢Õß√à“ß°“¬„ÀâÕ¬àŸ∑Ë’√–¥—∫∑Ë’°”À𥉫â ∂â“ √à“ß°“¬∫√‘‚¿§Õ“À“√¡“°‡°‘π‰ª„π«—πÀπ÷Ëß √à“ß°“¬°Á¡’·π«‚πâ¡∑Ë’®–≈¥°“√∫√‘‚¿§Õ“À“√„π«—π √àÿߢÈ÷π ∂â“√à“ß°“¬‰¥â√—∫Õ“À“√πâÕ¬°«à“ª√‘¡“≥∑Ë’‡À¡“– ¡ ∑Ë’®– “¡“√∂√—°…“πÈ”Àπ—°¢Õß√à“ß°“¬ „ÀâÕ¬àŸ∑’Ë√–¥—∫∑’Ë°”À𥉫â √à“ß°“¬°Á®–√⟠÷°À‘«Õ¬àŸ‡ ¡Õ °√–∫«π°“√ metabolism ®–≈¥≈ß ·µà¡’ª√– ‘∑∏‘¿“æ¡“°¢È÷π  àߺ≈„Àâπ”È Àπ—°µ—«‰¡à≈¥≈ßÕ¬à“ß√«¥‡√Á« ¡’¢âÕ ¡¡µ‘∞“π«à“„π§πÕâ«π °Õß°“√·æ∑¬∑å “ß‡≈◊Õ° °√¡æ≤— π“°“√·æ∑¬·å ºπ‰∑¬·≈–°“√·æ∑¬∑å “ß‡≈Õ◊ °

∫∑∑Ë’ 11 573 °“√Õ¥Õ“À“√·≈–°“√®”°¥— ·§≈Õ√’ ®”π«π¡“° πÈ”Àπ—°¢Õß√à“ß°“¬∂Ÿ°°”Àπ¥‰«â‚¥¬ªí®®—¬∑“ßæ—π∏ÿ°√√¡ ¥—ßπ—Èπ®÷߇ªìπ°“√¬“°∑’Ë®– ∑”„Àâæ«°‡¢“≈¥πÈ”Àπ—°‰¥â πÕ°®“°π’Ȭ—߇™◊ËÕ°—π«à“‰¢¡—π∑’Ë – ¡‰«â°Á‡ªìπÕ’°ªí®®—¬Àπ÷Ëß∑’˧«∫§ÿ¡ πÈ”Àπ—°√à“ß°“¬∑’Ë°”Àπ¥‰«â ·≈–‡¡◊ËÕ√–¥—∫¢Õß°√¥‰¢¡—πÕ‘ √–„π√–∫∫‰À≈‡«’¬π‚≈À‘µ Ÿß¢È÷π ‡π◊ÕË ß®“°¡’°“√ ≈“¬‰¢¡π— ∑ ’Ë – ¡ °“√∫√‘‚¿§Õ“À“√°®Á –≈¥≈ß ¬ß— ¡’ª®í ®—¬Õπ◊Ë Ê ∑Ë¡’ º’ ≈µàÕ°“√∫√‚‘ ¿§Õ“À“√ ŒÕ√å‚¡π glucagon ·≈– calcitonin ®“° µ∫— ÕÕà π ·≈– cholecsystokinin ®“°≈”‰ ‡â ≈°Á ° Á “¡“√∂≈¥§«“¡Õ¬“°Õ“À“√≈߉¥â ®”π«π¢Õ߇´≈≈å ‰¢¡—π “¡“√∂‡æË‘¡‰¥â‡¡◊ËÕ√à“ß°“¬¡’πÈ”Àπ—°‡æË‘¡¢È÷π ‚¥¬‡©æ“–Õ¬à“߬‘Ëß„π«—¬‡¥Á° ·µà®”π«π‡´≈≈åπ’È ‰¡à “¡“√∂≈¥≈߉¥â ªí®®—¬∑“ß®‘µ«‘∑¬“°Á¡’§«“¡ ”§—≠ ¡’°“√»÷°…“æ∫«à“¡È◊ÕÕ“À“√¥’Ê ∑Ë’∫â“𠇪πì §«“¡§«“¡æß÷ æÕ„®Õ¬“à ߬ßË‘  ß‘Ë ÀπßË÷ „π™«’ µ‘ √Õß®“°«π— À¬¥ÿ ß“π °®‘ °√√¡∑“ß‡æ» ·≈–°®‘ °√√¡ „π§√Õ∫§√«— º≈¢Õß°“√Õ¥Õ“À“√·≈–°“√®”°—¥·§≈Õ√µ’ àÕ°“√™–≈Õ§«“¡™√“ ‡¡◊ËÕ‡¢â“ àŸ«—¬™√“  ‘ËßÀπ÷Ëß∑Ë’¡πÿ…¬åµâÕߪ√– ∫ §◊Õ ‚√§¿—¬‰¢â‡®Á∫Õ—π‡°Ë’¬«‡π◊ËÕß°—∫§«“¡ ‡ ÕË◊ ¡¢Õß√à“ß°“¬ ‡™πà ‚√§À—«„®·≈–À≈Õ¥‡≈Õ◊ ¥ ‡∫“À«“π™π‘¥∑’ Ë Õß (‰¡æà ÷ßË Õ‘π´≈Ÿ ‘π) ·≈–¡–‡√Áß ‡ªìπµâπ ¡’ªí®®—¬‡ Ë’¬ß¡“°¡“¬∑Ë’∑”„À⇰‘¥‚√§‡À≈à“π’È ‡™àπ °“√∫√‘‚¿§Õ“À“√∑’Ë¡’·§≈Õ√’¡“°‡°‘π‰ª °“√‰¥â√—∫ “√«‘µ“¡‘π‰¡à‡æ’¬ßæÕ (‚¥¬‡©æ“–Õ¬à“߬ˑ߰√¥‚ø≈‘°·≈– “√µâ“πÕπÿ¡Ÿ≈Õ‘ √–) ·≈– °“√¢“¥°“√ÕÕ°°”≈ß— °“¬ π—∫·µàÕ¥’µ ¡’ß“π«‘®—¬®”π«π¡“°∑’Ë π—∫ πÿπº≈Õ—π‡ªìπ§ÿ≥¢Õß°“√Õ¥Õ“À“√·≈– °“√®”°—¥·§≈Õ√’ ß“π«‘®—¬ à«π„À≠à∑”„π —µ«å∑¥≈Õß ‚¥¬‡©æ“–Õ¬à“߬‘Ëß„π —µ«å‡≈’Ȭß≈Ÿ°¥â«¬π¡ ‡™àπ ÀπŸ¢“« ÀπŸ∂’∫®—°√ ·≈– ≈‘ß ‡ªìπµâπ ß“π«‘®—¬„π —µ«å∑¥≈Õ߇À≈à“π’È à«π„À≠à»÷°…“º≈ ¢Õß°“√®”°¥— ·§≈Õ√’ µàÕ§«“¡¡’Õ“¬¬ÿ ◊𬓫¢Õß —µ«å∑¥≈Õß ·≈–°≈‰°∑’∑Ë ”„À⇰‘¥º≈‡™àππÈ’ (µ“√“ß ∑Ë’ 2) Õ“® √ÿª‰¥â«à“ °“√Õ¥Õ“À“√·≈–°“√®”°—¥·§≈Õ√’„π —µ«å∑¥≈Õß¡’º≈µàÕ°“√§«∫§ÿ¡√–¥—∫ °≈Ÿ‚§ ·≈–‰¢¡—π„π‡≈◊Õ¥ πÕ°®“°π’È ¬—ß¡’º≈µàÕª√‘¡“≥‰¢¡—π„π√à“ß°“¬ °“√µÕ∫ πÕßµÕà Õπ‘ ´≈Ÿ π‘ °“√ √â“ß ‡µ’¬√Õ¬¥å ŒÕ√å‚¡π ·≈–ŒÕ√å‚¡π∑Ë’°√–µâÿπµàÕ¡‰∑√Õ¬¥å ∑È—ßÀ¡¥π’È∑”„ÀâÕ—µ√“°“√‡°‘¥ ‚√§®“°§«“¡‡ Ë◊Õ¡ ‡™àπ ‡∫“À«“π À≈Õ¥‡≈◊Õ¥ ·≈–§«“¡®”‡ ◊ËÕ¡‡°‘¥¢È÷ππâÕ¬≈ß º≈√«¡°Á§◊Õ °“√¡’Õ“¬¬ÿ ◊𬓫¡“°¢Èπ÷ °Õß°“√·æ∑¬∑å “ß‡≈Õ◊ ° °√¡æ≤— π“°“√·æ∑¬å·ºπ‰∑¬·≈–°“√·æ∑¬∑å “ß‡≈Õ◊ °

574 µ”√“«™‘ “°“√ Õ“À“√‡æÕ◊Ë  ÿ¢¿“æ µ“√“ß∑Ë’ 2 °“√»÷°…“º≈¢Õß°“√Õ¥Õ“À“√·≈–°“√®”°—¥·§≈Õ√’„π —µ«å∑¥≈Õß π—∫·µà ªï §.». 1996 - 2005  µ— «∑å ¥≈Õß º≈°“√»°÷ …“ ‡Õ° “√Õâ“ßÕ‘ß ≈‘ß Àπ¢Ÿ “« °“√®”°—¥·§≈Õ√™’ –≈Õ§«“¡™√“„π≈‘߉¥â Proc Natl Acad Sci U S A. 1996 Apr 30;93(9):4159-64 ≈‘ß Àπ‡Ÿ æ»‡¡¬’ ∑Ë’‰¥√â —∫Õ“À“√®”°¥— ·§≈Õ√’ Age Ageing. 1996 May; 25(3): 250-5 ≈‘ß ¡°’ “√‡ ◊ËÕ¡¢Õß√–∫∫ ∫◊ æπ— ∏ÿåÕπ— ‡πÕ◊Ë ß ÀπŸ∂’∫®—°√ ¡“®“° ‡µ¬’ √Õ¬¥Œå Õ√å‚¡π™“â ≈ß Àπ¢Ÿ “« °“√®”°¥— ·§≈Õ√’™–≈Õ°“√≈¥≈ߢÕß J Clin Endocrinol Metab. 1997 Jul; 82(7): adrenal steroids ∑¡’Ë ∫’ ∑∫“∑µÕà µ“â π 2093-6 ÀπŸ∂’∫®—°√ §«“¡™√“ ·≈–Àπ¢Ÿ “« °“√®”°—¥·§≈Õ√‡’ æ‘¡Ë °“√‡§≈ÕË◊ π‰À« Physiol Behav. 1997 Jul;62(1):97-103 ≈‘ß ∑”„À â µ— «∑å ¥≈Õß°√–©—∫°√–‡©ß¡“°¢È÷π ≈‘ß ÀπŸÕ“¬ÿ¡“°∑’ˉ¥â√∫— Õ“À“√®”°—¥·§≈Õ√’ Mech Ageing Dev. 1997 Feb;93(1-3):87-94 ¡√’ –¥∫— cytokines TNF-alpha ·≈– IL-6 ‰¡µà à“ß®“°ÀπÕŸ “¬ÿπÕâ ¬∑Ë’‰¥√â —∫Õ“À“√ ª°µ‘ °“√®”°¥— ·§≈Õ√’¡’º≈∑”„Àâ¿Ÿ¡‘§âÿ¡°—π J Clin Immunol. 1997 Jan;17(1):85-95 ‡æ‘¡Ë ¢÷πÈ ≈¥‚Õ°“ ‡ªπì ‚√§∑‡Ë’ °’ˬ«‡πËÕ◊ ß°—∫ §«“¡™√“ °“√®”°—¥·§≈Õ√’¡º’ ≈‡ª≈¬’Ë π·ª≈ß ÿ¢¿“æ Environ Res. 1997;73(1-2):242-8 „π∑“ß∑¥Ë’ ’ ´Ë÷ߧ«∫§¡ÿ ‚¥¬ hypothalamic- pituitary-adrenal axis ºà“π∑“ß√–∫∫ ŒÕ√å‚¡π °“√®”°—¥·§≈Õ√’ “¡“√∂≈¥Õ—µ√“°“√‡°¥‘ Toxicol Sci.1999 Dec;52(2 Suppl):49-55 欓∏‘ ¿“æ¢ÕßÀ≈Õ¥‡≈Õ◊ ¥·¥ß °“√®”°¥— ·§≈Õ√’‡ªπì √–¬–‡«≈“π“π∑”„Àâ J Gerontol A Biol Sci Med Sci. 1999 ¡°’ “√‡ª≈¬Ë’ π·ª≈ß metabolism ¢Õß Jan;54(1):B5-11; discussion B12-3 æ≈—ßß“π ·≈–∑”„Àâ —µ«∑å ¥≈Õ߉¡Õà â«π °Õß°“√·æ∑¬å∑“߇≈◊Õ° °√¡æ≤— π“°“√·æ∑¬·å ºπ‰∑¬·≈–°“√·æ∑¬∑å “ß‡≈Õ◊ °

∫∑∑Ë’ 11 575 °“√Õ¥Õ“À“√·≈–°“√®”°¥— ·§≈Õ√’  µ— «∑å ¥≈Õß º≈°“√»°÷ …“ ‡Õ° “√Õâ“ßÕ‘ß ÀπŸ∂’∫®—°√ Àπ¢Ÿ “« °“√®”°¥— ·§≈Õ√’™–≈Õ°“√‡°‘¥¡–‡√ßÁ Cancer Res. 1999 Apr 1;59(7):1642-8 „πÀπ∑Ÿ ¥ Õ∫·≈–∑”„ÀÕâ “¬¬ÿ ◊𬓫¢÷πÈ ≈‘ß Àπ¢Ÿ “« °“√®”°¥— ·§≈Õ√’‡æ¡‘Ë °“√‰À≈‡«’¬π‚≈À‘µ Neurobiol Aging. 1999 Mar-Apr;20(2):191-200 „πÀ≈Õ¥‡≈Õ◊ ¥ΩÕ¬¢Õß ¡Õß Àπ¢Ÿ “« ¢ÕßÀπ∑Ÿ ¥ Õ∫ Àπ¢Ÿ “« °“√®”°¥— ·§≈Õ√∑’ ”„Àâ√–¥∫— ¢ÕßπÈ”µ“≈ Toxicol Sci. 1999 Dec;52(2 Suppl):35-40 ≈‘ß ·≈–Õπ‘ ´≈Ÿ ‘π„π‡≈◊Õ¥≈¥≈ß ≈‘ß °“√®”°—¥·§≈Õ√’¡º’ ≈≈¥§«“¡¥—π‚≈À‘µ Toxicol Sci. 1999 Dec;52(2 Suppl):41-8 ≈¥‰¢¡π— ¢Õß√“à ß°“¬ ≈¥√–¥∫— ‰µ√°≈‡’ ´Õ‰√¥å ÀπŸ∂’∫®—°√ ·≈–§Õ‡≈ ‡µÕ√Õ≈ „π¢≥–∑‡Ë’ æË¡‘ √–¥—∫ ≈‘ß HDL „π‡≈◊Õ¥ ÀπŸ∂’∫®—°√ °“√®”°—¥·§≈Õ√∑’ ”„À⇴≈≈åÀ≈Õ¥‡≈Õ◊ ¥ Connect Tissue Res. 1999;40(2):131-43 ¢ÕßÀπ∑Ÿ ¥ Õ∫‡ ◊ËÕ¡™â“≈ß ‡¡◊ËÕ∂Ÿ°™—°π”„À⇪ìπ¡–‡√Áßµ—∫ Toxicol Sci. 1999 Dec;52(2 Suppl):17-23 ÀπŸ∑¥ Õ∫∑Ë’‰¥√â ∫— Õ“À“√®”°¥— ·§≈Õ√’ ‡°‘¥√Õ¬‚√§∑Ë’µ∫— πÕâ ¬≈ß°«“à ÀπŸª°µ‘ °“√Õ¥Õ“À“√∑”„À â µ— «∑å ¥≈Õß Eur J Clin Nutr. 2000 Jun;54 Suppl 3:S15-20 ¡’‰¢¡—ππÕâ ¬ ¬∫— ¬È—ßªí®®¬— À≈“¬Õ¬“à ß ∑°Ë’ Õà „À‡â °¥‘ §«“¡™√“ °“√®”°—¥·§≈Õ√’„π µ— «åÕ“¬ÿ¡“° ¬—∫¬Èß— Mech Ageing Dev. 2000 Jan 10;112(3):185-96 ª®í ®¬— À≈“¬Õ¬“à ß∑∑Ë’ ”„À‡â °‘¥¿“«–‡∫“À«“π ·≈–‚√§À≈Õ¥‡≈◊Õ¥À—«„® °“√ߥՓÀ“√„π∫“ß™à«ß∑”„ÀÀâ π∑Ÿ ¥ Õ∫ Mech Ageing Dev. 2000 May 18; ¡’™’«‘µ¬◊𬓫¢÷Èπ 115 (1-2):61-71 °“√®”°¥— ·§≈Õ√’ ¡º’ ≈™–≈Õ°“√ Exp Gerontol. 2000 Dec;35(9-10):1131-49 ‡ª≈¬Ë’ π·ª≈ß∑“ß √√’ –À≈“¬ª√–°“√ ∑∑Ë’ ”„À‡â °¥‘ §«“¡™√“ °“√®”°¥— ·§≈Õ√ ’ “¡“√∂√–ß—∫Õ“°“√ J Nutr Health Aging. 2000;4(3): 182-6 §«“¡®”‡ ◊ËÕ¡∑Ë’‡°¥‘ „πÀπŸÕ“¬ÿ¡“° °Õß°“√·æ∑¬å∑“߇≈◊Õ° °√¡æ≤— π“°“√·æ∑¬å·ºπ‰∑¬·≈–°“√·æ∑¬å∑“߇≈◊Õ°

576 µ”√“«™‘ “°“√ Õ“À“√‡æË◊Õ ÿ¢¿“æ  µ— «∑å ¥≈Õß º≈°“√»°÷ …“ ‡Õ° “√Õâ“ßÕ‘ß ≈‘ß ÀπŸ∂’∫®—°√ °“√®”°—¥·§≈Õ√¬’ ∫— ¬—Èß°“√≈¥≈ߢÕß J Clin Endocrinol Metab. plasma melatonin ´÷Ë߇ªìπ marker 2001 Jul; 86(7):3292-5 Àπ¢Ÿ “« ∑Ë’ —¡æπ— ∏°å ∫— §«“¡™√“ ≈‘ß Àπ¢Ÿ “« °“√®”°—¥·§≈Õ√’¡º’ ≈„π°“√§«∫§ÿ¡√–¥—∫ Am J Physiol Endocrinol Metab. πÈ”µ“≈·≈–ªÑÕß°—π¿“«–µâ“πÕπ‘ ´≈Ÿ π‘ 2001 Oct; 281(4):E757-65 parameters compared with those of otherwise normoinsulinemic monkeys. °“√®”°¥— ·§≈Õ√’¡º’ ≈∑”„ÀÀâ π∑Ÿ ¥ Õ∫ Laryngoscope. 2005 Mar; 115(3): 405-11. ¡’°“√‡ ◊ËÕ¡¢Õ߇´≈≈庑«Àπ—ß™â“≈ß °“√®”°¥— ·§≈Õ√¡’ ’º≈µâ“π°“√≈¥≈ߢÕß Horm Metab Res. 2002 Jul; 34(7):378-82 thyroid stimulating hormones „π µ— «å ∑’¡Ë ’Õ“¬¡ÿ “°¢È÷π ÀπŸÕ«â π∑’ˉ¥√â —∫Õ“À“√®”°—¥·§≈Õ√’ Obes Res. 2005 Apr; 13(4):693-702. ¡’πÈ”Àπ°— ≈¥≈ß·≈–¡™’ «’ µ‘ ¬◊𬓫¢πÈ÷ ‚√§·≈–§«“¡º‘¥ª°µ‘∑Õ’Ë “®ªÑÕß°π— À√Õ◊ √—°…“‰¥â‚¥¬°“√Õ¥Õ“À“√·≈–°“√®”°—¥·§≈Õ√’ ¡’À≈—°∞“π®“°º≈ß“π«‘®—¬®”π«π¡“° · ¥ß„Àâ‡ÀÁπ«à“°“√Õ¥Õ“À“√·≈–°“√®”°—¥ ·§≈Õ√’  “¡“√∂ªÑÕß°π— ·≈–∫”∫¥— √—°…“‚√§ ·≈–§«“¡º‘¥ª°µ¢‘ Õß√à“ß°“¬À≈“¬Ê Õ¬“à ߉¥â ß“π «‘®—¬‡À≈à“πÈ’°√–∑”„π —µ«å∑¥≈Õ߇ªìπ à«π„À≠à ·¡â°√–πÈ—π°Á¬—ß™’È„Àâ‡ÀÁ𧫓¡‡ªìπ‰ª‰¥â∑’Ë®–‰¥âº≈ ‡™πà ‡¥’¬«°—π„π¡πÿ…¬å ‚√§·≈–§«“¡º¥‘ ª°µ‡‘ À≈“à πÈ’‰¥â·°à ‚√§Õâ«π (Obesity) ‚√§Õâ«π ‡ªìπ°≈ÿà¡Õ“°“√∑Ë’‡°‘¥®“°À≈“¬ “‡Àµÿ ·¡â«à“§«“¡ ¡¥ÿ≈¢Õß°“√ ‡º“º≈“≠ æ≈—ßß“π·≈–ªí®®—¬∑“ßæ—π∏ÿ°√√¡®–µà“ß°—π‰ª„π·µà≈–§π ·µà°“√∫√‘‚¿§Õ“À“√¡“° ‡°‘π‰ªºπ«°°—∫°“√¢“¥°“√ÕÕ°°”≈—ß°“¬ °Á¬—߇ªìπªí®®—¬™’È¢“¥∑’Ë∑”„À⇰‘¥‰¢¡—π à«π‡°‘π„π √“à ß°“¬8 °“√»°÷ …“«®‘ ¬— ∑“ߧ≈π‘ °‘ À≈“¬§√ß—È æ∫«“à «∏‘ °’ “√∑¥Ë’ ∑’  ’Ë ¥ÿ „π°“√≈¥·≈–§«∫§¡ÿ π”È Àπ°— §Õ◊ °“√∫√‘‚¿§Õ“À“√∑’Ë¡’·§≈Õ√µ’ Ë”√à«¡°∫— °“√ÕÕ°°”≈—ß°“¬ ·≈–°“√ª√—∫惵‘°√√¡ ´ßË÷ πÕ°®“°™«à ¬ ≈¥¡«≈¢Õß√à“ß°“¬ (body mass) ·≈â« ¬—߇æ‘Ë¡°“√‡º“º≈“≠‰¢¡—π·≈–≈¥√–¥—∫¢Õ߉¢¡—π„π ‡≈◊Õ¥Õ’°¥â«¬9-13 °Õß°“√·æ∑¬å∑“߇≈Õ◊ ° °√¡æ≤— π“°“√·æ∑¬å·ºπ‰∑¬·≈–°“√·æ∑¬∑å “ß‡≈Õ◊ °

∫∑∑Ë’ 11 577 °“√Õ¥Õ“À“√·≈–°“√®”°—¥·§≈Õ√’ ¿“«–‡∫“À«“π (Diabetes) °“√»÷°…“„πÀπŸ∑¥≈Õßæ∫«à“ °“√„ÀâÕ“À“√‡ªìπ™à«ßÊ  ≈—∫°—∫°“√ߥՓÀ“√  “¡“√∂≈¥Õ∫ÿ µ— °‘ “√≥¢å Õß¿“«–‡∫“À«“π‰¥1â 4 ·≈–°“√»°÷ …“„π§πÕ«â π∑¡Ë’ ¿’ “«–‡∫“À«“π·∫∫∑’Ë 2 °“√∫√‘‚¿§Õ“À“√∑Ë’¡’·§≈Õ√’πâÕ¬¡“°‡ªìπ‡«≈“ 8  —ª¥“Àå Õ—π‡ªìπ¿“«–∑’˺Ÿâ‡¢â“√—∫°“√∑¥≈Õß ¬Õ¡√—∫‰¥â ∑”„Àâ√–¥—∫πÈ”µ“≈·≈–‰¢¡—π„π‡≈◊Õ¥ √«¡∑ȗߧ«“¡¥—π‚≈À‘µ≈¥≈ß ·≈–§ßÕ¬Ÿà‡™àππ—È𠉥âÕ’°ª√–¡“≥ 1 ªï15 πÕ°®“°π’È °“√∫√‘‚¿§Õ“À“√∑’Ë¡’·§≈Õ√’µ”Ë ¬—ß “¡“√∂≈¥√–¥—∫°≈Ÿ‚§ „π ‡≈◊Õ¥‰¥â ·¡®â –À¬¥ÿ °“√√°— …“¥â«¬«‘∏’Õ◊πË Ê √«¡∑ßÈ— Õπ‘ ´≈Ÿ ‘π16 ·µ à “¡“√∂≈¥ oxidative stress ≈߉¥â ‡æ’¬ß∫“ß à«π16 ·≈–¬ß— æ∫µÕà ‰ª«“à °“√∫√‘‚¿§Õ“À“√∑Ë’¡’∑—ßÈ ·§≈Õ√’·≈–§“√å‚∫‰Œ‡¥√µµ”Ë  “¡“√∂ ≈¥ª√‘¡“≥‰¢¡—π¿“¬„π√à“ß°“¬ ‡æË‘¡§«“¡‰«µàÕÕ‘π´Ÿ≈‘π ·≈–‡æ‘Ë¡√–¥—∫¢Õß HDL ‰¥âÕ¬à“ß¡’ ª√– ∑‘ ∏¿‘ “æ¡“°°«“à Õ“À“√∑¡Ë’ ’·§≈Õ√µ’ Ë”‡æ’¬ßÕ¬à“߇¥’¬«17 §«“¡¥π— ‚≈Àµ‘  ßŸ „π§πÕâ«π∑’Ë¡’¿“«–§«“¡¥—π‚≈À‘µ Ÿß °“√∫√‘‚¿§Õ“À“√∑’Ë¡’·§≈Õ√’µË”™à«¬‡ √‘¡ ƒ∑∏‘Ï¢Õß atrial natriuretic peptide (ANP) „π°“√§«∫§ÿ¡§«“¡¥π— ‚≈À‘µ19 ª√∫— °“√∑”ß“π¢Õß √–∫∫ª√– “∑ vagus ·≈–≈¥§«“¡µâ“π∑“πÕ‘π´Ÿ≈‘π20 °“√»÷°…“∑Ë’πà“ π„®§√—ÈßÀπË÷ß´Ë÷ß„Àâ ºŸâ∑Ë’¡’¿“«–§«“¡¥—π‚≈À‘µ Ÿß∫√‘‚¿§‡©æ“–º—°·≈–º≈‰¡â‡ªìπ‡«≈“ 1-2 «—𠵓¡¥â«¬°“√ߥՓÀ“√ ‚¥¬¬Õ¡„Àâ∫√‘‚¿§πȔլà“߇¥’¬« ‡ªìπ‡«≈“‡©≈Ë’¬ 13.6 «—π ·≈â«®÷ß„Àâ∫√‘‚¿§Õ“À“√¡—ß «‘√—µ‘∑Ë’¡’ ‰¢¡π— ·≈–‚´‡¥’¬¡µË”Õ°’ 6 «—π °Õà π°≈∫— ¡“ à°Ÿ “√∫√‚‘ ¿§Õ“À“√ª°µ‘ æ∫«“à ‡ªπì «∏‘ ’∑ª’Ë ≈Õ¥¿—¬·≈–  “¡“√∂≈¥§«“¡¥—π‚≈À‘µÕ¬à“߉¥âº≈ ´÷Ë߬—ßÕ“® àߺ≈„Àâ¡’°“√‡ª≈Ë’¬π惵‘°√√¡°“√∫√‘‚¿§µàÕ‰ª Õ°’ ¥â«¬ 21 ‚√§À≈Õ¥‡≈Õ◊ ¥·¢Áßµ«— (atherosclerosis) √“¬ß“π∑“ߧ≈π‘ °‘ ™È’„À‡â ÀπÁ «“à °“√∫√‚‘ ¿§Õ“À“√∑¡’Ë ·’ §≈Õ√π’ Õâ ¬¡“° πÕ°®“°™«à ¬ ≈¥π”È Àπ—°·≈â« ¬—ß≈¥§«“¡‡ ’ˬߵàÕ°“√‡°‘¥‚√§À≈Õ¥‡≈◊Õ¥·≈–À—«„® ≈¥ myocardial oxidative stress ·≈–≈¥ post ischemic inflammatory response22-25 °“√»÷°…“§«“¡Àπ“¢Õߺπ—ß À≈Õ¥‡≈◊Õ¥·¥ß·§‚√µ‘¥ (carotid artery intimae-media thickness, IMT) ´Ë÷߇ªìπµ—«∫àß™’È ¿“«–À≈Õ¥‡≈◊Õ¥·¢Áßµ—«√–¬–‡√Ë‘¡·√°æ∫«à“ °“√∫√‘‚¿§Õ“À“√®”°—¥·§≈Õ√’„π√–¬–¬“«¡’º≈ ªÕÑ ß°—π°“√‡°‘¥‚√§À≈Õ¥‡≈Õ◊ ¥·¢Áßµ—«‰¥â 26 ‚√§≈¡™°— °“√»÷°…“„πÀπŸ∂’∫®—°√æ∫«à“ glycolysis „π ¡Õß ·≈–√–¥—∫¢Õß plasma glucose ¡’º≈µàÕ§«“¡‰«„π°“√‡°‘¥≈¡™—° ·≈–°“√∫√‘‚¿§Õ“À“√®”°—¥·§≈Õ√’ (√âÕ¬≈– 15)  “¡“√∂≈¥Õµ— √“°“√™—°‰¥Õâ ¬à“ß¡’π¬—  ”§—≠ 27, 28 °Õß°“√·æ∑¬å∑“߇≈◊Õ° °√¡æ≤— π“°“√·æ∑¬·å ºπ‰∑¬·≈–°“√·æ∑¬å∑“߇≈◊Õ°

578 µ”√“«™‘ “°“√ Õ“À“√‡æÕË◊  ¢ÿ ¿“æ §«“¡º¥‘ ª°µ‘∑ºË’ ‘«Àπ—ß (Skin disorders) „πºŸâªÉ«¬√“¬Àπ÷Ëß´Ë÷߇ªìπ chronic urticaria µâÕß√—°…“¥â«¬°“√©’¥ glucocorti- costeroids æ∫«à“ ‡¡◊ËÕ∑”°“√√—°…“√à«¡°—∫°“√Õ¥Õ“À“√ √Õ¬ºË◊π·¥ß‡√Ë‘¡≈¥≈ß„π«—π∑Ë’ 3 ¢Õß °“√√—°…“·≈–‰¡àª√“°Ø‡≈¬„π«π— ∑’Ë 1129 °“√»°÷ …“„πºŸâª«É ¬‚√§º«‘ Àπ—ß·∫∫ÕË◊πÊ ‰¥·â °à pustulo- sis palmaris et plantaris ·≈– atopic eczema æ∫«à“ °“√Õ¥Õ“À“√∑”„ÀâºâŸªÉ«¬¡’Õ“°“√ ¥¢’ π÷È ´÷ËßÕ“®‡°Ë’¬«¢âÕß°—∫√–¥—∫¢Õß lactoferrin (glycoprotein ∑ËÀ’ ≈Ëß— ®“°‡¡Á¥‡≈◊Õ¥¢“«„π¢≥–∑’Ë ‡°‘¥°“√Õ—°‡ ∫) ·≈–°“√∑”Àπâ“∑Ë’¢Õ߇¡Á¥‡≈◊Õ¥¢“« 30 πÕ°®“°π’È °“√»÷°…“„π —µ«å∑¥≈Õ߬—ß æ∫«à“ÀπŸ∂’∫®—°√∑Ë’∂Ÿ°™—°π”„À⇪ìπ contact dermatitis (¥â«¬ 2, 4-dinitrofluorobenzene, DNFB) ‡¡Ë◊ÕÕ¥Õ“À“√„π√–¬–‡«≈“ —Èπ §◊Õ 24 ™Ë—«‚¡ß°àÕπ·≈–À≈—ß°“√™—°π” ¡’°“√‡ª≈Ë’¬π·ª≈ß ∑“߇πÈÕ◊ ‡¬ËÕ◊ 欓∏‘«∑‘ ¬“À≈“¬Õ¬“à ß„π∑“ß∑Ë’¥¢’ ÷πÈ 31 ‚√§¿Ÿ¡‘·æâ·≈–‚√§¢Õâ Õ—°‡ ∫√¡Ÿ “µÕ¬¥å °“√»°÷ …“„π°≈¡àÿ º∑Ÿâ Ë¡’ √’ –¥—∫‰¢¡—π„π‡≈◊Õ¥ Ÿß«—¬°≈“ߧπæ∫«à“ °“√∫√‘‚¿§Õ“À“√∑Ë’ ¡’‰¢¡—πµË” („Àæâ ≈ß— ß“π√Õâ ¬≈– 15) ‡ªπì ‡«≈“ 12  ª— ¥“Àå ∑”„Àπâ ”È Àπ°— µ«— ≈¥≈߉¥â ·≈–‰¡à‡æ¬’ ß ·µà‰¡≈à ¥ ·µ¬à ß— ‡æ¡‘Ë °“√µÕ∫ πÕß„π√–∫∫¿¡Ÿ §‘ ¡âÿ °π— Õ°’ ¥«â ¬32 πÕ°®“°π°È’ “√°”Àπ¥™π¥‘ ¢ÕßÕ“À“√ ·≈–ª√‘¡“≥æ≈—ßß“π∑Ë’‰¥â√—∫¬—ߙ૬§«∫§ÿ¡√–¥—∫¢Õß tumour necrosis factor-alpha (TNF- alpha) ·≈– interleukin-1beta (IL-1beta) „πºŸâªÉ«¬∑‡Ë’ ªπì ‚√§¢âÕÕ—°‡ ∫√¡Ÿ “µÕ¬¥å (rheumatoid arthritis) Õ°’ ¥«â ¬ 33 ‚√§¡–‡√ßÁ °“√»÷°…“„πÀπŸ¢“«æ∫«à“ °“√®”°—¥·§≈Õ√’„π√–¥—∫ª“π°≈“ß “¡“√∂≈¥Õ—µ√“ °“√‡°‘¥‡πÕÈ◊ ßÕ°¢Õß pituitary, adrenal glands, pancreas ·≈– mammary glands34 ‰¥â ‚¥¬ ‡©æ“–Õ¬à“ß¬Ë‘ß ‡¡◊ËÕ„ÀâÀπŸ∂’∫®—°√°‘πÕ“À“√®”°—¥·§≈Õ√’ 10 ‡¥◊Õπ æ∫«à“  “¡“√∂¢®—¥ oxidative damage ∑’‡Ë °¥‘ ®“° clofibrate ´÷ßË ‡ªπì  “√°àÕ¡–‡√Á߉¥Õâ ¬à“ß ¡∫Ÿ√≥å 35 πÕ°®“°πÈ’°“√»÷°…“„πÀπŸ∂’∫®—°√¬—ßæ∫«à“ Õ“À“√®”°—¥·§≈Õ√’¡’º≈Õ¬à“߬ˑߵàÕ‡´≈≈å ∑’°Ë ”≈—ß·∫àßµ«— ¡“°°«à“‡´≈≈å∑·Ë’ ∫àßµ«— ·≈â« ¥—ßπÈπ— ®÷ß≈¥Õ—µ√“°“√‡µ∫‘ ‚µ¢Õ߇πÕ◊È ßÕ°‰¥â 36 °“√πÕπÀ≈—∫‰¡ªà °µ‘ „π§π∑‡’Ë ªπì ‚√§Õ«â π °“√ – ¡¢Õ߉¢¡π— ∫√‡‘ «≥¥“â π¢“â ߢÕß∑“߇¥π‘ À“¬„® «à π∫π ∑”„À‡â °¥‘ °“√Õ¥ÿ µπ— ·≈–‡°¥‘ °“√À¬¥ÿ À“¬„®‡ªπì ™«à ßÊ „π√–À«“à ß°“√πÕπÀ≈∫— (obstructive sleep apnoea) °“√≈¥ª√‘¡“≥·§≈Õ√’„πÕ“À“√ ´÷Ëß¡’º≈≈¥°“√ – ¡‰¢¡—π “¡“√∂·°â‰¢¿“«–π’ȉ¥â °Õß°“√·æ∑¬å∑“߇≈Õ◊ ° °√¡æ—≤π“°“√·æ∑¬å·ºπ‰∑¬·≈–°“√·æ∑¬∑å “ß‡≈◊Õ°

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586 µ”√“«™‘ “°“√ Õ“À“√‡æ◊ÕË  ¢ÿ ¿“æ ‡Õ° “√Õ“â ßÕß‘ 1. McCay, C.M., Crowell, M.F., Maynard, L.A., 1935. The effect of retarded growth upon the length of life-span and upon the ultimate body size. J. Nutr. 10, 63-79. 2. Weindruch, R., Walford, R.L., 1988. In: Thomas, Charles, C. (Ed.), The Retardation of Aging and Disease by Dietary Restriction. Springfield, IL.Sprott, R.L., 1997. Diet and calorie restriction. Exp. Gerontol. 32, 205-214. 3. Chapman, T., Partridge, L., 1996. Female fitness in Drosophila melanogaster and interaction between the effect of nutrition and of encounter rate with males. Proc. R. Soc. Lond. Ser. B Biol. Sci. 263, 755-759. 4. Houthoofd, K., Braeckman, B.P., Lenaerts, I., Brys, K., De Vreese, A., V an Eygen, S., Vanfleteren, J.R., 2002. Axonic growth up-regulates mass-specific metabolic rate, stress resistance, and extends life-span in Caenorhabditis elegans. Exp. Gerontol. 37, 1371-1378. 5. Weindruch, R., Sohal, R.S., 1997. Seminars in medicine of the Beth Israel Deaconess Medical Center: caloric intake and aging. N. Engl. J. Med. 337, 986-994. 6. Hart, R.W.,Turturro, A.,1998. Evolution and dietary restriction. Exp. Gerontol.33, 53-60. 7. Skrha J, Kunesova M, Hilgertova J, Weiserova H, Krizova J, Kotrlikova E. 2005. Short-term very low calorie diet reduces oxidative stress in obese type 2 diabetic patients. Physiol Res. 54(1):33-9. 8. Gustaviani R, Soewondo P, Semiardji G, Sudoyo AW., 2004. The influence of calorie restriction during the Ramadan fast on serum fructosamine and the formation of beta hydroxybutirate in type 2 diabetes mellitus patients. Acta Med Indones. Jul-Sep;36(3):136-41. 9. Johnstone AM, Faber P, Andrew R, Gibney ER, Elia M, Lobley G, Stubbs RJ, Walker BR. 2004. The pathophysiology of obesity, Gac Med Mex. Jul-Aug;140 Suppl 2: S27-32. 10. Williamson DA, Stewart TM. 2005. Behavior and lifestyle: approaches to treatment of obesity, J La State Med Soc. ;157 Spec No 1:S50-5. °Õß°“√·æ∑¬∑å “ß‡≈Õ◊ ° °√¡æ—≤π“°“√·æ∑¬·å ºπ‰∑¬·≈–°“√·æ∑¬å∑“߇≈◊Õ°

∫∑∑Ë’ 11 587 °“√Õ¥Õ“À“√·≈–°“√®”°¥— ·§≈Õ√’ 11. Raymond NC, de Zwaan M, Mitchell JE, Ackard D, Thuras P. 2002. Effect of a very low calorie diet on the diagnostic category of individuals with binge eating disorder, Int J Eat Disord. 31(1):49-56 12. Ivkovic-Lazar T. 2001. Treatment of extreme obesity with a very low calorie diet. Med Pregl. 54(11-12):534-8 13. Anderson JW, Vichitbandra S, Qian W, Kryscio RJ. 1999. Long-term weight maintenance after an intensive weight-loss program. J Am Coll Nutr. 18(6):620-7 14. Pedersen CR; Hagemann I; Bock T; Buschard K, 1999. Intermittent feeding and fasting reduces diabetes incidence in BB rats. Autoimmunity 30(4): 243-50. 15. Dhindsa P; Scott AR; Donnelly R, 2003. Metabolic and cardiovascular effects of very-low-calorie diet therapy in obese patients with Type 2 diabetes in secondary failure: outcomes after 1†year. Diabetic Medicine 20 (4), 319-324. 16. Molokhia M. 1998. Obesity wars: a pilot study of very low calorie diets in obese patients in general practice. Br J Gen Pract. 48(430):1251-2 17. Jazet IM, Pijl H, Frolich M, Romijn JA, Meinders AE. 2005. Two days of a very low calorie diet reduces endogenous glucose production in obese type 2 diabetic patients despite the withdrawal of blood glucose-lowering therapies including insulin. Metabolism. 54(6):705-12. 18. Skrha J, Kunesova M, Hilgertova J, Weiserova H, Krizova J, Kotrlikova E.2005. Short-term very low calorie diet reduces oxidative stress in obese type 2 diabetic patients. Physiol Res. 54(1):33-9. 19. Miyashita Y, Koide N, Ohtsuka M, Ozaki H, Itoh Y, Oyama T, Uetake T, Ariga K, Shirai K. 2004. Beneficial effect of low carbohydrate in low calorie diets on visceral fat reduction in type 2 diabetic patients with obesity. Diabetes Res Clin Pract. 65(3):235-41. 20. Dessi-Fulgheri P, Sarzani R, Serenelli M, Tamburrini P, Spagnolo D, Giantomassi L, Espinosa E, Rappelli A.1999. Low calorie diet enhances renal, hemody- namic, and humoral effects of exogenous atrial natriuretic peptide in obese hypertensives. Hypertension. 33(2):658-62 °Õß°“√·æ∑¬∑å “ß‡≈◊Õ° °√¡æ—≤π“°“√·æ∑¬å·ºπ‰∑¬·≈–°“√·æ∑¬∑å “ß‡≈Õ◊ °

588 µ”√“«™‘ “°“√ Õ“À“√‡æËÕ◊  ÿ¢¿“æ 21. Nakano Y, Oshima T, Sasaki S, Higashi Y, Ozono R, Takenaka S, Miura F, Hirao H, Matsuura H, Chayama K, Kambe M.2001. Calorie restriction reduced blood pressure in obesity hypertensives by improvement of autonomic nerve activity and insulin sensitivity. J Cardiovasc Pharmacol. 38 Suppl 1:S69-74 22. Goldhamer AC, Lisle DJ, Sultana P, Anderson SV, Parpia B, Hughes B, Campbell TC.2002. Medically supervised water-only fasting in the treatment of borderline hypertension. J Altern Complement Med 8(5):643-50 23. Pekkarinen T; Takala I; Mustajoki P. 1998. Weight loss with very-low-calorie diet and cardiovascular risk factors in moderately obese women: one-year follow-up study including ambulatory blood pressure monitoring. Int J Obes Relat Metab Disord. 22(7):661-6 24. Colcombe SJ, Erickson KI, Raz N, Webb AG, Cohen NJ, McAuley E, Kramer AF. 2001.Calorie restriction attenuates inflammatory responses to myocardial ischemia-reperfusion injury. Am J Physiol Heart Circ Physiol. 280(5): H2094-102 25. Akehi Y, Yoshimatsu H, Kurokawa M, Sakata T, Eto H, Ito S, Ono J. 2001. VLCD-induced weight loss improves heart rate variability in moderately obese Japanese. CExp Biol Med (Maywood) ;226(5):440-5 26. Brehm BJ, Seeley RJ, Daniels SR, DûAlessio DA. 2003. A randomized trial comparing a very low carbohydrate diet and a calorie-restricted low fat diet on body weight and cardiovascular risk factors in healthy womeny. J Clin Endocrinol Metab.88(4): 1617-23 27. Fontana L, Meyer TE, Klein S, Holloszy JO. 2004. Long-term calorie restriction is highly effective in reducing the risk for atherosclerosis in humans.Proc Natl Acad Sci U S A. 101(17): 6659-63. 28. Greene AE, Todorova MT, McGowan R, Seyfried TN. 2001. Caloric restriction inhibits seizure susceptibility in epileptic EL mice by reducing blood glucose. Epilepsia 42(11):1371-8 29. Mantis JG, Centeno NA, Todorova MT, McGowan R, Seyfried TN. 2004. Management of multifactorial idiopathic epilepsy in EL mice with caloric restriction and the ketogenic diet: role of glucose and ketone bodies. Nutr Metab (Lond). 19;1(1):11. °Õß°“√·æ∑¬∑å “ß‡≈◊Õ° °√¡æ≤— π“°“√·æ∑¬å·ºπ‰∑¬·≈–°“√·æ∑¬∑å “ß‡≈Õ◊ °

∫∑∑’Ë 11 589 °“√Õ¥Õ“À“√·≈–°“√®”°—¥·§≈Õ√’ 30. Okamoto O, Murakami I, Itami S, Takayasu S.1992. Fasting diet therapy for chronic urticaria: report of a case. J Dermatol. 19(7):428-31 31. Lithell H, Bruce A, Gustafsson IB, Hoglund NJ, Karlstrom B, Ljunghall K, Sjolin K, Venge P, Werner I, Vessby B. 1983. A fasting and vegetarian diet treatmenttrial on chronic inflammatory disorders. Acta Derm Venereol 63(5):397-403 32. Nakamura H, Kouda K, Fan W, Watanabe T, Takeuchi H. 2001. Suppressive effects on allergic contact dermatitis by short-term fasting. 2001.Toxicol Pathol.;29(2): 200-7 33. Santos MS, Lichtenstein AH, Leka LS, Goldin B, Schaefer EJ, Meydani SN. 2003. Immunological effects of low-fat diets with and without weight loss, J Am Coll Nutr. 22(2):174-82. 34. Karatay S, Erdem T, Yildirim K, Melikoglu MA, Ugur M, Cakir E, Akcay F, Senel K. 2004. The effect of individualized diet challenges consisting of allergenic foods on TNF-alpha and IL-1beta levels in patients with rheumatoid arthritis. Rheumatology (Oxford). 43(11):1429-33. 35. R. Dixit, J. B. Coleman, B. Mattson, G. C. Ballam and K. P. Keenan, 1998. The effects of uncontrolled excess caloric intake, and moderate to marked caloric restriction (CR) on obesity, spontaneous diseases and cancers in Sprague-Dawley (SD) rats, Toxicology Letters,95, Suppl (1)182 36. Bin Qu, Barry Halliwell, Choon Nam Ong, Bee Lan Lee and Qiu-Tian Li. 2000. Caloric restriction prevents oxidative damage induced by the carcinogen clofibrate in mouse liver, FEBS Letters, 473 (1) 85-88 37. Stephen R. Spindler. 2005. Rapid and reversible induction of the longevity, anticancer and genomic effects of caloric restriction. Mechanisms of Ageing and Development. 126 (9) 960-966 38. Choi J, Kim D. 2004. Effects of Age and Dietary Restriction on Lifespan and Oxidative Stress of SAMP8 Mice with Learning and Memory impairments. J Nutr Health Aging. 4(3):182-186. °Õß°“√·æ∑¬∑å “ß‡≈Õ◊ ° °√¡æ—≤π“°“√·æ∑¬·å ºπ‰∑¬·≈–°“√·æ∑¬å∑“߇≈Õ◊ °

590 µ”√“«™‘ “°“√ Õ“À“√‡æ◊ÕË  ÿ¢¿“æ 39. Sweet RJ, Price JM, Henry KR. 1988. Dietary restriction and presbyacusis: periods of restriction and auditory threshold losses in the CBA/J mouse. Audiology. 27(6):305-12 40. Henry KR. 1986. Effects of dietary restriction on presbyacusis in the mouse. Audiology. 25(6):329-37. 41. Seidman MD. 2000. Effects of dietary restriction and antioxidants on presbyacusis. Laryngoscope 110(5 Pt 1):727-38. 42. Quigley K; Goya R; Meites J. 1987. Rejuvenating effects of 10-week underfeeding period on estrous cycles in young and old rats. Neurobiol Aging 8(3):225-32. 43. Katsuki A, Sumida Y, Ito K, Murashima S, Gabazza EC, Furuta M, Yano Y, Sugiyama T, Toyoda N, Adachi Y. 2000. A case of obesity, diabetes and hyperten- sion treated with very low calorie diet (VLCD) followed by successful pregnancy with intrauterine insemination (IUI). Endocr J. 47(6):787-91. 44. Grinspoon SK; Baum HB; Kim V; Coggins C, 1995. Klibanski A.Decreased bone formation and increased mineral dissolution during acute fasting in young women. Clin Endocrinol Metab. 80(12):3628-33. 45. Lane MA, Black A, Handy AM, Shapses SA, Tilmont EM, Kiefer TL, Ingram DK, Roth GS. 2001. Energy restriction does not alter bone mineral metabolism or reproductive cycling and hormones in female rhesus monkeys. J Nutr. 131(3): 820-7. 46. Black A, Allison DB, Shapses SA, Tilmont EM, Handy AM, Ingram DK, Roth GS, Lane MA. 2001. Calorie restriction and skeletal mass in rhesus monkeys (Macaca mulatta): evidence for an effect mediated through changes in body size. J Gerontol A Biol Sci Med Sci. 56(3):B98-107. 47. Salin-Pascual RJ, Upadhyay U, Shiromani PJ. 2002. Effects of hypocaloric diet on sleep in young and old rats. Neurobiol Aging. 23(5):771-6. 48. Kansanen M, Vanninen E, Tuunainen A, Pesonen P, Tuononen V, Hartikainen J, Mussalo H, Uusitupa M. 1998. The effect of a very low-calorie diet-induced weight loss on the severity of obstructive sleep apnoea and autonomic nervous function in obese patients with obstructive sleep apnoea syndrome. Clin Physiol. 18(4):377-85 °Õß°“√·æ∑¬å∑“߇≈Õ◊ ° °√¡æ≤— π“°“√·æ∑¬å·ºπ‰∑¬·≈–°“√·æ∑¬å∑“߇≈◊Õ°

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∫∑∑’Ë 12 595 Õ“À“√ª≈Õ¥®“° “√æ…‘ ∫∑∑Ë’ 12 Õ“À“√ª≈Õ¥®“° “√æ…‘ (Toxin - Safe Foods) √». ¥√. «ß»å«‘«—≤πå ∑—»π’¬°ÿ≈ º». ¥√.  æÿ µ— √“ ª√»æÿ ≤— π“ ∫∑π” ªí®®ÿ∫—𧫓¡ ”§—≠¥â“πÕ“À“√ª≈Õ¥¿—¬ (food safety) ‰¥â√—∫°“√¬Õ¡√—∫Õ¬à“ß °«â“ߢ«“ß«à“ ¡’ à«π ”§—≠Õ¬à“߬ˑߵàÕ°“√√≥√ߧå·≈–·π«ªØ‘∫—µ‘µà“ßÊ ¥â“π “∏“√≥ ÿ¢ ‚¥¬‡©æ“–Õ¬à“߬‘Ëß µàÕ°“√ªÑÕß°—πÀ√◊Õ≈¥Õÿ∫—µ‘°“√≥å°“√‡°‘¥‚√§À√◊Õ‰¥â√—∫ “√æ‘…®“°°“√ √—∫ª√–∑“πÕ“À“√Àπ૬ߓπµà“ßÊ ∑Ë’‡°Ë’¬«¢âÕߵȗ߷µà√–¥—∫‚≈° √–¥—∫ª√–‡∑» À√◊Õ·¡â·µà Àπ૬ߓπÕË◊πÊ ‰¥â∑ÿࡇ∑§«“¡æ¬“¬“¡¡“°¡“¬‡æ◊ËÕ„À⇰‘¥§«“¡ª≈Õ¥¿—¬„π°“√∫√‘‚¿§Õ“À“√ ´÷Ëߧ«“¡æ¬“¬“¡„π√Ÿª·∫∫µà“ßÊ ‡À≈à“πÈ’ ‡ªìπº≈¡“®“°§«“¡µ√–À𗰄𧫓¡ª≈Õ¥¿—¬®“° Õ“À“√∑Ë’√—∫ª√–∑“π ∑È—ßπÈ’‡æ◊ËÕ„Àâª√–™“°√ª≈Õ¥®“°§«“¡‡®Á∫ªÉ«¬∑’ˇ°‘¥®“°Õ“À“√ (foodborne illness) π—πË ‡Õß Õߧ尓√Õπ“¡—¬‚≈° (World Health Organization) ‰¥â„Àâ𑬓¡¢Õߧ«“¡‡®Á∫ªÉ«¬ ∑Ë’‡°‘¥®“°Õ“À“√ À¡“¬∂÷ß ç§«“¡‡®Á∫ªÉ«¬„¥Ê ∑Ë’Õ“®‡°‘¥®“°°“√µ‘¥‡™È◊ÕÀ√◊Õ°“√‰¥â√—∫ “√æ‘… ´Ëß÷ ‡¢“â  √Ÿà à“ß°“¬®“°°“√√∫— ª√–∑“πÕ“À“√é §«“¡‡®Á∫ªÉ«¬∑Ë’‡°‘¥®“°Õ“À“√√«¡∑È—ß∑Ë’ —¡æ—π∏å°—∫°“√∫√‘‚¿§Õ“À“√ ®—¥‡ªìπªí≠À“ ¥â“π “∏“√≥ ÿ¢∑Ë’ ”§—≠µàÕ∑ÿ°¿Ÿ¡‘¿“§„π‚≈°πÈ’ ∑È—ß„πª√–‡∑»∑Ë’æ—≤π“·≈â«·≈–ª√–‡∑»°”≈—ß æ—≤π“ π—∫µÈ—ß·µà‡™È◊Õ°àÕ‚√§∑Ë’ªπ‡ªóôÕπ„πÕ“À“√ (foodborne pathogens) ‰ª®π∂÷ß “√æ‘… ªπ‡ªôóÕπ„πÕ“À“√∑È—ß®“° ‘Ëß·«¥≈âÕ¡·≈– “√æ‘…∑Ë’‡°‘¥®“°°√–∫«π°“√ª√ÿßÕ“À“√  “‡Àµÿ‡À≈à“πÈ’ ≈«â π·≈â«·µ‡à °Ë¬’ «¢âÕß‚¥¬µ√ß°—∫§«“¡‡®Á∫ª«É ¬„π√Ÿª·∫∫µ“à ßÊ µßÈ— ·µªà í≠À“°“√µ¥‘ ‡™Õ◊È ∑’ˉ¡à√πÿ ·√ß ‰ª®π∂÷ß‚√§¡–‡√Áß∑Ë’‡ªìπ∑’ˬա√—∫°—π·≈â««à“¡’ “‡Àµÿ à«πÀπË÷ß∑Ë’ —¡æ—π∏å°—∫°“√√—∫ª√–∑“πÕ“À“√ πÕ°®“°πÈ’®–‡ÀÁπ‰¥â«à“·¡â«à“‡∑§‚π‚≈¬’¢Õß‚≈°¡’§«“¡°â“«ÀπⓇæ‘Ë¡¢È÷πÕ¬à“ß¡“°¡“¬ ªí≠À“¥â“𠧫“¡‡®∫Á ª«É ¬∑‡’Ë °¥‘ ®“°Õ“À“√°≈—∫‰¡à‰¥≈â ¥≈ß·µ¬à —ߧ߇ªìπªí≠À“ ”§≠— ‡ ¡Õ¡“ °Õß°“√·æ∑¬∑å “ß‡≈Õ◊ ° °√¡æ≤— π“°“√·æ∑¬·å ºπ‰∑¬·≈–°“√·æ∑¬å∑“߇≈◊Õ°

596 µ”√“«™‘ “°“√ Õ“À“√‡æÕË◊  ¢ÿ ¿“æ  ”À√—∫ª√–‡∑»‰∑¬ ªí≠À“Õ“À“√‡ªìπæ…‘ À√Õ◊ ‚√§Õ“À“√‡ªπì æ…‘ (foodborne-illness) π—∫‡ªìπªí≠À“¥â“π “∏“√≥ ÿ¢∑’Ë∫Ë—π∑Õ𧫓¡‡ªìπÕ¬Ÿà∑’Ë¥’¢Õߪ√–™“™π‰∑¬¡“™â“π“π ‚√§Õ“À“√ ‡ªìπæ‘…µ“¡∑’Ë¡’√“¬ß“π≈à“ ÿ¥ ‚¥¬°≈ÿࡇΩÑ“√–«—ß·≈– Õ∫ «π‚√§  ”π—°√–∫“¥«‘∑¬“ °Õߧ«∫§¡ÿ ‚√§ °√–∑√«ß “∏“√≥ ¢ÿ „πªï æ.». 2548 (°≈ÿ¡à ‡ΩÑ“√–«ß— ·≈– Õ∫ «π‚√§, 2548) ‰¥â√—∫√“¬ß“π∑È—ß È‘π 140,949 √“¬ §‘¥‡ªìπÕ—µ√“ªÉ«¬ 226.62 µàÕª√–™“°√· π§π ∑Ë’πà“ —߇°µ §◊ÕÕ—µ√“ª«É ¬¥â«¬‚√§Õ“À“√‡ªìπæ‘…„πª√–‡∑»‰∑¬¡·’ π«‚πâ¡ Ÿß¢πÈ÷ „π™à«ß 10 ªï∑’˺“à π¡“ ‚¥¬‡æË¡‘ ®“° 136.87 µàÕª√–™“°√· π§π„πªï 2539 ‡ªìπ 226.62 µàÕª√–™“°√· π§π„πªï 2548 ·≈–®—¥‡ªìπÕ—π¥—∫µâπÊ ¢Õß‚√§∑Ë’¡’°“√‡ΩÑ“√–«—ß„πª√–‡∑»‰∑¬ µ—«‡≈¢∑’ˇæ‘Ë¡¢È÷ππÈ’πÕ°®“°Õ“®®– À¡“¬∂÷ß√–∫∫°“√√“¬ß“π·≈–√«∫√«¡¢Õâ ¡≈Ÿ ∑Ë’¥¢’ ÷Èπ ∑”„À°â “√√“¬ß“π‡ªìπ‰ªÕ¬“à ß¡ª’ √– ‘∑∏¿‘ “æ ·≈â« ¬—ßÕ“®Õπÿ¡“π‰¥â∂÷ß ¿“槫“¡‡ªìπÕ¬àŸ¢Õߧπ‰∑¬∑’ˬ—ߧߡ’§«“¡‡ Ë’¬ßµàÕ°“√‡°‘¥‚√§Õ“À“√ ‡ªπì æ…‘ °Á‰¥â ¥—ßπ—Èπ °“√∫√‘‚¿§Õ¬à“ߪ≈Õ¥¿—¬ ®÷߉¡à„™à‡√◊ËÕ߉°≈µ—«∑Ë’§«√∂Ÿ°¡Õߢⓡ ª√–™“™π ∑ÿ°§π„π∞“π–∑ȗ߇ªìπºâŸ∫√‘‚¿§À√◊Õ¡’§«“¡‡°’ˬ«¢âÕß°—∫°“√º≈‘µÕ“À“√ ®÷ߧ«√¡’§«“¡µ√–Àπ—° ·≈–¡’§«“¡√Ÿâ‡æ◊ËÕ°“√®—¥°“√¥â“πÕ“À“√ª≈Õ¥¿—¬‰¥âÕ¬à“ß¡’ª√– ‘∑∏‘¿“æ ‡πÈ◊ÕÀ“„π∫∑π’È®÷ß¡’ §«“¡§√Õ∫§≈ÿ¡∂÷ߧ«“¡√ŸâæÈ◊π∞“π‡°Ë’¬«°—∫Õ“À“√ª≈Õ¥¿—¬  “√ªπ‡ªôóÕπµà“ßÊ ∑Ë’æ∫ ·≈–¡’ √“¬ß“π«à“¡’°“√ªπ‡ªôóÕπ·≈–∑”„À⇰‘¥‚∑…·°àºâŸ∑Ë’∫√‘‚¿§‡¢â“‰ª ‰¡à«à“®–‡ªìπ “√ªπ‡ªóôÕπ∑Ë’‡°‘¥ ®“°°√–∫«π°“√ª√ßÿ Õ“À“√  “√æ…‘ ∑“ß™«’ ¿“殓°‡™Õ◊È √“ ‚≈À–Àπ°— ªπ‡ªÕôó π„πÕ“À“√  “√ª√“∫ »—µ√Ÿæ◊™µ°§â“ß µ≈Õ¥®π∂÷ß°“√‡≈◊Õ°√—∫ª√–∑“πÕ¬à“ߪ≈Õ¥¿—¬„πª√–™“°√°≈ÿࡵà“ßÊ ´÷Ëß ªØ‘ ¡— æ—π∏√å –À«à“ßÕ“À“√·≈–‚√§  “√ªπ‡ªôÕó π„πÕ“À“√∑’ˇ°‘¥®“°°√–∫«π°“√ª√ßÿ Õ“À“√¥«â ¬§«“¡√âÕπ πÕ°‡Àπ◊Õ®“°°“√ªπ‡ªôóÕπ¢Õß “√µà“ßÊ „πÕ“À“√ ∑’Ë¡’∑’Ë¡“®“° ‘Ëß·«¥≈âÕ¡·≈â« ¬—ßæ∫«à“°√–∫«π°“√ª√ÿßÕ“À“√‡Õß°Á‡ªìπ·À≈àß°àÕ “√ªπ‡ªôóÕπ∑Ë’¡’‚∑…µàÕ√à“ß°“¬‰¥â ‚¥¬‡©æ“– Õ¬à“߬ˑ߰“√ª√ÿßÕ“À“√‚¥¬„™â§«“¡√âÕπ ‡Àµÿ∑Ë’ “√ªπ‡ªóôÕπ‡À≈à“π’ȉ¥â√—∫§«“¡ π„®‡ªìπ摇»… °Á‡π◊ËÕߥ⫬«à“ “√∫“ßµ—«¡’§«“¡‡ªìπæ‘…„π√Ÿª·∫∫∑’Ë —¡æ—π∏å°—∫°“√‡°‘¥¡–‡√Áß ∑”„À⥟‡À¡◊Õπ«à“ °“√√—∫ —¡º—  “√‡À≈à“πÈ’‡ªìπ Ë‘ß∑’ËÀ≈’°‡≈’ˬ߉¥â¬“° ‡πË◊Õß®“°√Ÿª·∫∫°“√ª√ÿßÕ“À“√¬—ߧߵâÕß Õ“»—¬§«“¡√âÕπ ‚¥¬‡©æ“–√Ÿª·∫∫°“√ª√ÿßÕ“À“√‰∑¬∑Ë’¡’§«“¡À≈“¬À≈“° ‰¡à«à“®–‡ªìπ°“√ªîôß °“√¬à“ß À√◊Õ°“√∑Õ¥ „π∫√√¥“ “√ªπ‡ªôóÕπ„πÕ“À“√∑’ˇ°‘¥®“°°“√ª√ÿßÕ“À“√¥â«¬§«“¡√âÕπ ∑’ˉ¥√â ∫— §«“¡ π„®·≈–¡°’ “√»°÷ …“¡“°∑ ’Ë ¥ÿ 3 ™π¥‘ ·√° ‰¥·â °à polycyclic aromatic hydrocarbons heterocyclic amines ·≈– acryl amide °Õß°“√·æ∑¬å∑“߇≈◊Õ° °√¡æ—≤π“°“√·æ∑¬å·ºπ‰∑¬·≈–°“√·æ∑¬å∑“߇≈◊Õ°

∫∑∑’Ë 12 597 Õ“À“√ª≈Õ¥®“° “√æ‘… ‚æ≈´’ —¬§≈‘°Õ–‚√¡“µ‘°‰Œ‚¥√§“√å∫Õπ ‚æ≈´’ ¬— §≈°‘ Õ–‚√¡“µ°‘ ‰Œ‚¥√§“√∫å Õπ (Polycyclic aromatic hydrocarbons /PAHS) ®—¥‡ªìπ°≈àÿ¡ “√‡§¡’∑’ˇ°‘¥®“°°√–∫«π°“√‡º“‰À¡â∑Ë’‰¡à ¡∫Ÿ√≥å (incomplete combustion) ¢Õß ∂“à πÀ‘π π”È ¡—π ·°ä  ‰¡â·≈–«—µ∂Õÿ π‘ ∑√¬’ µå “à ßÊ  “√°≈àÿ¡ PAHs Õ“®∂Ÿ° ß— ‡§√“–Àå¢πÈ÷ À√Õ◊ ‡°¥‘ ‰¥‡â Õß „π∏√√¡™“µ‘ °“√ªπ‡ªôÕó π¢Õß “√°≈à¡ÿ PAHs  “¡“√∂æ∫‰¥â∑«Ë— ‰ª∑ß—È ®“°πÈ” ¥π‘ Õ“°“» ‰ª®π∂÷ß °“√æ∫ – ¡„πæ◊™º—° º≈‰¡â ‡πÈ◊Õ —µ«å ‰¢¡—π —µ«å Õ“À“√∑–‡≈ √«¡∂÷ß°“√ – ¡„πÕ“À“√ ‡π◊ÕË ß®“°°√–∫«π°“√¢π àß·≈–°“√‡°Á∫Õ“À“√ (Janszka, B., ·≈–§≥–, 2004) Õ¬“à ߉√°µÁ “¡  “‡ÀµÿÀ≈—°¢Õß°“√ªπ‡ªôóÕπ¢Õß “√°≈ÿà¡ PAHs æ∫«à“‡°‘¥®“°°“√ª√ÿßÕ“À“√‚¥¬„™â§«“¡√âÕ𠇪ìπ à«π„À≠à ‡¡Ë◊Õ¡’°“√ª√ÿßÕ“À“√ ‚¥¬‡©æ“–Õ¬à“߬ˑ߇π◊ÈÕ —µ«å·≈–ª≈“ ‰¡à«à“®–‡ªìπ°“√ª√ÿß ¥â«¬§«“¡√âÕπ‚¥¬°“√ªôîß ¬à“ß À√◊Õ√¡§«—π æ∫«à“¡’°“√ √â“ß “√°≈àÿ¡ PAHs ®“°ªØ‘°‘√‘¬“°“√  ≈“¬µ—«¥â«¬§«“¡√âÕπ¢Õß “√ª√–°Õ∫Õ‘π∑√’¬å À√◊Õ∑Ë’‡√’¬°«à“ªØ‘°‘√‘¬“‰æ‚√‰≈´‘  (pyrolysis reaction) ‡πË◊Õß®“°‡¡◊ËÕ “√Õ‘π∑√’¬å‚¥¬‡©æ“–‰¢¡—π —µ«å‡¡Ë◊Õ‰¥â√—∫§«“¡√âÕπ Ÿß ®–≈–≈“¬ ·≈– À¬¥≈ß∫π∂à“π√âÕπ ∑”„Àâ¡’°“√‡ª≈’ˬπ√Ÿª¢Õß “√ª√–°Õ∫Õ‘π∑√’¬å¢Õ߉¢¡—π®πÕ¬Ÿà„π√Ÿª¢Õß PAHs ´Ë÷ߪ√–°Õ∫¥â«¬«ß·À«πµÈ—ß·µà 4-6 «ß ‡√’¬ßµ—«µàÕ°—π (√Ÿª∑’Ë 1) ·≈–‡§≈◊Õ∫µ‘¥∫πº‘«™È‘π Õ“À“√ °“√‡°‘¥¢÷Èπ¢Õß “√°≈ÿà¡ PAHs π’È¡’§«“¡ —¡æ—π∏å‚¥¬µ√ß°—∫ª√‘¡“≥‰¢¡—π„πÕ“À“√ ·≈–√–¥—∫§«“¡√âÕπ∑’Ë„™â πË—π§◊Õ ¬‘Ëß¡’ª√‘¡“≥‰¢¡—π≈–≈“¬À¬¥≈ß∫π∂à“π√âÕπ¡“° ·≈–¬‘Ëß„™â Õÿ≥À¿Ÿ¡‘ Ÿß ‚¥¬‡©æ“–„π™à«ß√–À«“à ß 400-1,000 Õß»“‡´≈‡´’¬  ª√¡‘ “≥ PAHs ∑ˇ’ °‘¥¢πÈ÷ °Á Ÿß µ“¡‰ª¥â«¬ ¥—ßπÈ—π °“√„™â‡µ“¬à“ß·∫∫¡’√–∫∫ªÑÕß°—π°“√‡°‘¥ªØ‘°‘√‘¬“‰æ‚√‰≈´‘  ®– “¡“√∂≈¥ ª√‘¡“≥ PAHs ∫π™‘ÈπÕ“À“√‰¥â¡“° (Jagerstad, M., ·≈–§≥–, 2005) „π°√≥’¢ÕßÕ“À“√ √¡§«—π °“√ – ¡¢Õß PAHs „πÕ“À“√¡“®“° PAHs „𧫗π∑‡Ë’ °“–‡§≈Õ◊ ∫∫πÕ“À“√ππÈ— Ê √ªŸ ∑Ë’ 1 µ«— Õ¬à“ß‚§√ß √“â ß “√°≈ÿà¡ Polycyclic aromatic hydrocarbons ∑Ëæ’ ∫„π ßË‘ ·«¥≈Õâ ¡·≈–µ√«®æ∫ „πÕ“À“√ (∑’¡Ë “ : Phillips, D.H.,1999) °Õß°“√·æ∑¬∑å “ß‡≈◊Õ° °√¡æ≤— π“°“√·æ∑¬å·ºπ‰∑¬·≈–°“√·æ∑¬∑å “ß‡≈Õ◊ °

598 µ”√“«™‘ “°“√ Õ“À“√‡æ◊ÕË  ¢ÿ ¿“æ 1) °“√‡ª≈¬’Ë π·ª≈ß “√°≈¡àÿ PAHs „π√“à ß°“¬„ÀÕâ ¬àŸ„π√ªŸ  “√°Õà ¡–‡√ßÁ (Metabolic bioactivation of PAHs to carcinogens)  “√°≈¡ÿà PAHs ‡∑“à ∑∑’Ë √“∫‚§√ß √“â ß·π™à ¥— ª®í ®∫ÿ π— ¡¡’ “°°«“à 100 ™π¥‘ „π®”π«ππÈ’ ¡’ª√–¡“≥ 54 ™π‘¥∑Ë’¡’√“¬ß“π«à“¡’§«“¡‡ªìπæ‘…µàÕ ‘Ëß¡’™’«‘µ ·≈–¡’ 11 ™π‘¥∑’Ë¡’ƒ∑∏Ï‘°àÕ¡–‡√Áß ∑™’Ë ¥— ‡®π„π µ— «∑å ¥≈Õß·≈–§“¥«“à  “¡“√∂‡Àπ¬Ë’ «π”„À‡â °¥‘ ¡–‡√ßÁ „π¡π…ÿ ¬å‰¥‡â ™πà °π— (Monograph, 1983) §ÿ≥ ¡∫—µ‘‚¥¬∑Ë—«‰ª¢Õß “√°≈àÿ¡ PAHs æ∫«à“¡’§«“¡§ßµ—« Ÿß ≈–≈“¬π”È ‰¥âπâÕ¬·≈–‡¢â“ ∑”ªØ‘°‘√‘¬“∑“߇§¡’°—∫ “√Õ◊Ëπ‰¥âπâÕ¬ Õ¬à“߉√°Áµ“¡®“°§ÿ≥ ¡∫—µ‘∑Ë’≈–≈“¬„π‰¢¡—π‰¥â¥’ ‡¡Ë◊Õ‡¢â“ àŸ √“à ß°“¬ “√°≈ÿ¡à PAHs ®–∂Ÿ°¥Ÿ¥´÷¡‰¥Õâ ¬à“ß√«¥‡√«Á ·≈– – ¡µ“¡‡πÕ◊È ‡¬Õ◊Ë µ“à ßÊ  “√°≈ÿà¡ PAHs ¬—ߧߡ’§ÿ≥ ¡∫—µ‘§≈⓬ “√°àÕ¡–‡√Áß à«π„À≠à§◊Õ¡—°Õ¬àŸ„π ¿“æ ‡©Ë◊Õ¬„π∏√√¡™“µ‘·µà‡¡Ë◊Õ‡¢â“ àŸ√à“ß°“¬ ‘Ëß¡’™’«‘µ‰¡à«à“®–‡ªìπ —µ«åÀ√◊Õ¡πÿ…¬åµâÕßÕ“»—¬°√–∫«π°“√ ‡ª≈¬Ë’ π·ª≈ß‚¥¬„™‡â Õπ‰´¡å cytochrome P-450 (CYP) „π√“à ß°“¬‡æÕ◊Ë „ÀÕâ ¬Ÿà„π√ªŸ ¢Õß “√°Õà ¡–‡√ßÁ ∑’ËÕÕ°ƒ∑∏Ï‘‰¥â ‡¥‘¡∑‡’ ™◊ËÕ°π— «à“‡©æ“–‡Õπ‰´¡å CYP1A1 ‡∑à“πÈπ— ∑’Ë∑”ß“π‡æË◊Õ‡ª≈Ë’¬π PAHs „ÀÕâ ¬àŸ „π√ªŸ ∑¡’Ë §’ «“¡‰« ßŸ (reactive nucleophiles) „π¡π…ÿ ¬·å ≈– µ— «™å 𥑠µ“à ßÊ ·µµà Õà ¡“æ∫«“à CYP1B1  “¡“√∂∑”ß“π‰¥â‡™àπ‡¥’¬«°—π ∑—Èß CYP1A1 ·≈– CYP1B1 æ∫‰¥â„πÕ«—¬«–µà“ßÊ πÕ°‡Àπ◊Õ ®“°µ—∫ (extrahepatic organs) ®÷߇ªπì ‡Àµÿ„À â “¡“√∂‡°¥‘ ¡–‡√ßÁ ®“°°“√√—∫ ¡— º—  “√°≈à¡ÿ PAHs „π —µ«å∑¥≈Õß„πÀ≈“¬Õ«—¬«– °“√‡ª≈Ë’¬π·ª≈ß “√°≈àÿ¡ PAHs ®÷߇°‘¥¢È÷π‰¥âµ“¡‡π◊ÈÕ‡¬Ë◊Õ∑—Ë«‰ª‚¥¬¡’À≈“¬ °√–∫«π°“√∑’ˇ°Ë’¬«¢âÕß ‡¡µ“∫Õ‰≈∑å∑Ë’‰¥â®“°°“√‡ª≈’ˬπ·ª≈ß “√„π°≈ÿà¡π’È ‰¥â·°à epoxide intermediates dihydrodiols phenols quinones ·≈–ÕË◊πÊ  “√°≈ÿà¡ phenols quinones ·≈– dihydrodiols ®–°“√√«¡µ—« (conjugation) °∫— °≈Ÿ§‘«‚√‰π¥å (glucuronides) ·≈–´≈— ‡øµ‡Õ ‡∑Õ√å (sulfate esters)  «à 𧫑‚ππ®–√«¡µ«— °∫— °≈Ÿµ“‰∏‚Õπ‰¥‡â ªπì °≈Ÿµ“‰∏‚Õπ§Õπ®Ÿ‡°µ (glutathione conjugate) ´÷Ëß≈–≈“¬πÈ”‰¥â¥’·≈–∂Ÿ°¢—∫ÕÕ°πÕ°√à“ß°“¬ ‚¥¬∫“ß à«π®–‡¢â“ àŸ°√–∫«π°“√ ‡ª≈Ë’¬π·ª≈ß‚¥¬ CYP µÕà ‰ª „π°√≥µ’ «— Õ¬à“ߢÕß “√„π°≈ÿà¡ PAHs ∑ Ë’ ”§≠— µ«— ÀπËß÷ §◊Õ ‡∫π‚´ ‡Õ‰æ√π’ (benzo[a]pyrene; B[a]P) æ∫«“à πÕ°®“° dihydrodiols ®–‡°¥‘ °“√√«¡µ—«‡æ◊ËÕ¢∫— ÕÕ° πÕ°√“à ß°“¬·≈«â ∫“ß «à π¬ß— Õ“®¡°’ “√‡ª≈¬’Ë π·ª≈ßµÕà ‰ªÕ°’ ‚¥¬ CYP ‰¥·â °‡à Õπ‰´¡å CYP1A1 ·≈– CYP1B1 ‰¥ â “√°≈¡ÿà epoxides §◊Õ (+)- ·≈– (-)-B[a]P-7,8-oxide ®“°ππÈ— ®–∂Ÿ°‡ª≈Ë’¬π·ª≈ß µÕà ¥â«¬‡Õπ‰´¡å epoxide hydrolase ∑ËÕ’ ¬¿Ÿà “¬„π‰¡‚§√‚´¡‰¥‡â ªìπ (+)- ·≈– (-)-B[a]P-7 8-diol µ“¡≈”¥—∫ º≈‘µ¿—≥±å∑’ˇ°‘¥¢È÷π„π¢—ÈπµÕππ’Ȭ—߉¡à®—¥«à“¡’ƒ∑∏‘χªìπ “√°àÕ¡–‡√Áß ·µàÀ≈—ß®“°∂Ÿ° ‡ª≈’ˬπ·ª≈ßÕ’°§√ȗߥ⫬ CYP ®–‰¥â (+)-B[a]P-7 8-diol-9 10-epoxide-1 (+)-B[a]P-7 8-diol-9,10-epoxide-2 (-)-B[a]P-7 8-diol-9 10-epoxide-1 ·≈– (-)-B[a]P-7 8-diol-9 °Õß°“√·æ∑¬å∑“߇≈Õ◊ ° °√¡æ≤— π“°“√·æ∑¬å·ºπ‰∑¬·≈–°“√·æ∑¬∑å “ß‡≈◊Õ°

∫∑∑’Ë 12 599 Õ“À“√ª≈Õ¥®“° “√æ…‘ 10-epoxide-2 (√ªŸ ∑Ë’ 2) ´÷ßË diol-epoxide ∑Ë’‡°‘¥¢÷Èπ∑È—ß 4 µ—«πÈ’„Àºâ ≈‡Àπ’ˬ«π”°“√°àÕ°≈“¬æ—π∏ÿå ®“°°“√∑¥ Õ∫¥â«¬«‘∏’‡Õ¡ å (Ames test) ∑È—ß È‘π πÕ°®“°πÈ’¬—ßæ∫«à“ (+)-B[a]P-78-diol-9 10-epoxide-2  “¡“√∂‡ÀπË’¬«π”„À⇰‘¥¡–‡√Áß„πÀπŸ∑’ˇ°‘¥„À¡à (Tang, ·≈–§≥–, 2000) ‚¥¬ƒ∑∏Ï‘ °àÕ¡–‡√Á߇°‘¥®“°°“√∑’Ë “√‡À≈à“π’È “¡“√∂®—∫°—∫¥’‡ÕÁπ‡Õ´Ë÷߇ªìπÀπ૬æ—π∏ÿ°√√¡¢Õß√à“ß°“¬ ‰¥¥â ’ ∑”„À‡â °¥‘ benzo[a]pyrene-adduct º“à π∑“ߪذ‘ √‘ ¬‘ “°“√‡µ¡‘ À¡ÕŸà ≈— §≈’ (alkylation reaction) ∑Ë’µ”·Àπàß exocyclic nitrogen (N-2) deoxyguanosine ‰¥â‡ªìπ benzo[a]pyrene epoxide- deoxyguanosine ·≈– “¡“√∂ àߺ≈„À⇴≈≈凰‘¥°“√‡ª≈’ˬπ·ª≈ߥâ“𧫓¡º‘¥ª°µ‘„π°“√ ·∫àßµ—«¢Õ߇´≈≈®å π°≈“¬‡ªìπ‡´≈≈¡å –‡√ßÁ „π∑Ë’ ÿ¥ √Ÿª∑Ë’ 2 °√–∫«π°“√‡ª≈’¬Ë π·ª≈ß Benzo[a]pyrene (B[a]P) „π√à“ß°“¬„ÀÕâ ¬àŸ„π√ªŸ epoxide ‚¥¬ CYP450 ·≈–‡Õπ‰´¡å epoxide hydrolase (∑Ë’¡“ : Shimada, T., ·≈–§≥–, 2004) ®“°¢Õâ ¡≈Ÿ ∑¬Ë’ π◊ ¬π— ∂ß÷ ∫∑∫“∑¢Õß CYP1A1 ·≈– CYP1B1 „π°√–∫«π°“√‡ª≈¬Ë’ π·ª≈ß  “√°≈àÿ¡ PAHs „ÀâÕ¬àŸ„π√Ÿª∑Ë’ “¡“√∂°àÕ¡–‡√Á߇¡Ë◊Õ‡¢â“ Ÿà√à“ß°“¬ Ë‘ß¡’™’«‘µ‰¥âπÈ—π ‰¥â¡’°“√»÷°…“ ‡æ¡‘Ë ‡µ¡‘ „π√–¥—∫æπ— ∏°ÿ √√¡∂ß÷ °“√æ∫§«“¡º¥‘ ·º°∑“ßæπ— ∏°ÿ √√¡ (genetic polymorphism) ¢Õß ‡Õπ‰´¡∑å È—ß Õßµ—«πÈ’ ·µà„π·ß¢à Õߧ«“¡ —¡æ—π∏√å –À«“à ߧ«“¡º¥‘ ·º°∑“ßæ—π∏°ÿ √√¡¢Õß CYP1A1 ·≈– CYP1B1 °—∫°“√‡°‘¥¡–‡√Áß„π§π·≈â«π—Èπ ¬—ß‰¡à‡ªìπ∑’Ë √ÿª·πà™—¥«à“§«“¡º‘¥·º°¢Õß ‡Õπ‰´¡å∑ß—È  Õßµ«— πÈ’‡ªπì  “‡Àµ„ÿ À·â µà≈–∫§ÿ §≈¡’§«“¡æ√âÕ¡ (susceptibility) µÕà °“√‡°‘¥¡–‡√Áß®“° °“√√—∫ —¡º—  “√°≈àÿ¡ PAHs ‰¥âµà“ß°—π ∑È—ßπ’ÈÕ“®‡πË◊Õß®“°°“√¡’ªí®®—¬ÕË◊π∑’ˇ°Ë’¬«¢âÕß°—∫°“√‡°‘¥ ¡–‡√ßÁ ‡¢“â ¡“‡°¬’Ë «¢âÕß ®ß÷ ¬ß— µÕâ ßÕ“»¬— °“√»÷°…“·≈–¢Õâ ¡≈Ÿ ‡æË¡‘ ‡µ‘¡Õ’°µÕà ‰ª °Õß°“√·æ∑¬∑å “ß‡≈Õ◊ ° °√¡æ≤— π“°“√·æ∑¬å·ºπ‰∑¬·≈–°“√·æ∑¬å∑“߇≈Õ◊ °

600 µ”√“«™‘ “°“√ Õ“À“√‡æË◊Õ ¢ÿ ¿“æ 2) §«“¡ ¡— æπ— ∏√å –À«“à ß°“√√∫—  —¡º—  “√°≈¡àÿ PAHs „πÕ“À“√°—∫°“√‡°¥‘ ¡–‡√Áß °“√»°÷ …“„π µ— «∑å ¥≈Õß·≈–¢Õâ ¡≈Ÿ ∑“ß√–∫“¥«∑‘ ¬“· ¥ß„À‡â ÀπÁ «“à  “√°≈¡ÿà PAHs  “¡“√∂∑”„À⇰‘¥¡–‡√Á߇¡◊ËÕ‡¢â“ àŸ√à“ß°“¬¢Õß Ë‘ß¡’™’«‘µ„π«‘∂’∑“ßµà“ßÊ ‰¥â∑È—ß È‘π ‰¡à«à“®–‡ªìπ°“√ À“¬„® °“√√—∫ª√–∑“π À√◊Õ°“√ —¡º— ∑“ߺ‘«Àπ—ß ‚¥¬°“√À“¬„®æ∫«à“‡∫π‚´‡Õ‰æ√’π∑”„À⇰‘¥ ¡–‡√ßÁ ªÕ¥·≈–¡–‡√ßÁ „π√–∫∫∑“߇¥π‘ À“¬„® √«¡∂ß÷ ¡–‡√ßÁ À≈Õ¥Õ“À“√„π µ— «∑å ¥≈Õß ´ßË÷  Õ¥§≈Õâ ß °—∫¢âÕ¡Ÿ≈°“√»÷°…“∑“ß√–∫“¥«‘∑¬“∑’Ë· ¥ß„Àâ‡ÀÁ𧫓¡ —¡æ—π∏å∑’Ë™—¥‡®π√–À«à“ß°“√√—∫ —¡º—   “√°≈àÿ¡ PAHs ∑“ß°“√À“¬„®°—∫°“√‡°‘¥¡–‡√Áߪե„π§πß“π‚√ßß“π·≈–ºâŸ Ÿ∫∫ÿÀ√Ë’ „π·ßà¢Õß °“√ªπ‡ªóôÕπ„πÕ“À“√æ∫«à“ “√°≈àÿ¡ PAHs À≈—° “¡™π‘¥∑’Ë¡’√“¬ß“π°“√æ∫„πÕ“À“√‰¥â·°à benzo[a]pyrene, banzo[a]anthracene ·≈– dibenz[a,h]anthracene ´÷Ëß∑—ÈßÀ¡¥π’ȉ¥â√—∫°“√ 殑 “√≥“„À⇪πì ç “√∑ÕË’ “®¡’ƒ∑∏Ï‘°àÕ¡–‡√Áßé (probably carcinogen) À√Õ◊ ®¥— Õ¬àŸ„π°≈¡ÿà 2A µ“¡ ‡°≥±å°“√®—¥ª√–‡¿∑ “√°àÕ¡–‡√Áß‚¥¬ International Agency for Research on Cancer (IARC) ‚¥¬Õ“»—¬¢âÕ¡Ÿ≈®“°°“√»÷°…“„π —µ«å∑¥≈Õß·≈–°“√‡°Á∫¢âÕ¡Ÿ≈∑“ß√–∫“¥«‘∑¬“ ·¡â«à“®–¬—߉¡à¡’ ¢âÕ¡Ÿ≈„¥∑’Ë· ¥ß™—¥‡®π«à“°“√∫√‘‚¿§ “√°≈àÿ¡ PAHs ∑”„À⇰‘¥¡–‡√Áß„π§π ‡π◊ËÕß®“°‰¡à “¡“√∂ ∑”°“√»÷°…“ƒ∑∏‘Ï°àÕ¡–‡√Áß‚¥¬µ√ß„π§π‰¥â√«¡∑È—ß°“√¥”‡√ß™’«‘µª√–®”«—π¢Õߧπ‡√“°Á¡’‚Õ°“  °“√√—∫ —¡º—  “√µà“ßÊ ‰¥âæ√âÕ¡°π— À≈“¬µ«— Õ¬Ÿà·≈«â ·µ°à ¡Á √’ “¬ß“π∑·Ë’  ¥ß§«“¡‡™Ë◊Õ¡‚¬ß√–À«à“ß °“√‡æË¡‘ ¢π÷È ¢ÕßÕ∫ÿ µ— °‘ “√≥°å “√‡°¥‘ ¡–‡√Áß°∫— °“√∫√‚‘ ¿§Õ“À“√∑¡Ë’ ’ª√¡‘ “≥ PAHs  ßŸ 3) °“√»°÷ …“ “√°≈¡àÿ PAHs „ππÈ”¡π— ∑Õ¥´”È ·≈–§«“¡ ¡— æπ— ∏°å ∫— °“√‡°¥‘ Õπ— µ√“¬ ®“°°“√∫√‘‚¿§πÈ”¡—π∑Õ¥´”È „π°“√°”Àπ¥§à“§«“¡ª≈Õ¥¿—¬¢Õß°“√√—∫ —¡º—  “√°≈àÿ¡ PAHs ®“°Õ“À“√‰¥â¡’ °“√°”Àπ¥‰«â™—¥‡®π‚¥¬ Commission regulation ·Ààߧ≥–°√√¡“∏‘°“√¬ÿ‚√ª (European Commission) „π¢âÕ°”Àπ¥∑Ë’ 208/2005 ∂ß÷ ª√¡‘ “≥ Ÿß ¥ÿ ¢Õ߇∫π‚´‡Õ‰æ√’π„ππ”È ¡—πÀ√◊Õ‰¢¡—π ∑Ë’„™â„π«—µ∂ÿª√– ß§å¢Õß°“√∫√‘‚¿§‚¥¬µ√ß·≈–‡ªìπ à«πª√–°Õ∫¢ÕßÕ“À“√∑’ˉ¡à‡°‘π 2 ppb (European Commission, 2005) °“√°”Àπ¥ª√‘¡“≥¥—ß°≈à“«π’È¡’ª√–‡¥Áπ°“√‡™Ë◊Õ¡‚¬ß‰ª∂÷ß °“√‡°¥‘ ¢πÈ÷ ¢Õß “√°≈àÿ¡ PAHs ®“°°“√„™πâ ”È ¡π— „π°“√∑Õ¥Õ“À“√ ®“°°“√»÷°…“∑“ß√–∫“¥«‘∑¬“ ‚¥¬‡©æ“–°“√»÷°…“„π∑«’ª‡Õ‡™’¬æ∫«à“ µ√’™“«‡Õ‡™’¬∂Ÿ°®—¥Õ¬Ÿà„π°≈àÿ¡∑’Ë¡’°“√‡°‘¥¡–‡√Áߪե Ÿß ∑ ’Ë ¥ÿ „π‚≈° §“¥«“à π“à ®– ¡— æπ— ∏°å ∫— °“√‰¥√â ∫— §«π— ®“°°“√ª√ßÿ Õ“À“√ π°— «®‘ ¬— À≈“¬∑“à π„À§â «“¡‡ÀπÁ «à“§«“¡‡ Ë’¬ß¢Õß°“√‡°‘¥¡–‡√Áß„πºâŸ∑Ë’√—∫ —¡º— §«—πÕ“À“√‡æË‘¡¢È÷π·≈– —¡æ—π∏å°—∫°“√¡’ “√°≈àÿ¡ PAHs „π§«π— ∑‡Ë’ °¥‘ ®“°π”È ¡π— ∑Õ¥ º≈°“√»°÷ …“À≈“¬™πÈ‘ π”¡“ ªàŸ √–‡¥πÁ §”∂“¡«“à  “√°≈¡ÿà PAHs ´Ë÷߇ªìπ “√°àÕ¡–‡√Áßæ∫‰¥â‡©æ“–„𧫗𮓰π”È ¡—π∑Õ¥À√◊Õ‰¡à·≈–æ∫‰¥â„ππÈ”¡—π∑Õ¥¥â«¬À√◊Õ‰¡à „π°“√π’È¡’π—°«‘®—¬À≈“¬§≥–· ¥ß„Àâ‡ÀÁπ«à“·¡âÕÿ≥À¿Ÿ¡‘∑’ˇÀ¡“– ¡¢Õß°“√‡°‘¥ “√°≈àÿ¡ PAHs °Õß°“√·æ∑¬∑å “ß‡≈◊Õ° °√¡æ—≤π“°“√·æ∑¬·å ºπ‰∑¬·≈–°“√·æ∑¬å∑“߇≈◊Õ°

∫∑∑Ë’ 12 601 Õ“À“√ª≈Õ¥®“° “√æ‘… ®–Õ¬Ÿà∑’Ë 660-740 Õß»“‡´≈‡´’¬  ¬—ßæ∫«à“‡¡◊ËÕºà“π°√–∫«π°“√„À⧫“¡√âÕπ·°àπÈ”¡—π∑Õ¥∑’Ë Õÿ≥À¿¡Ÿ ª‘ √–¡“≥ 180-270 Õß»“‡´≈‡´’¬ °Á “¡“√∂‡°‘¥ “√°≈ÿà¡ PAHs „ππ”È ¡π— ∑Õ¥‰¥â (Moret, S., ·≈–§≥– 2000, Purcaro, G., ·≈–§≥–, 2006) ·µªà √¡‘ “≥∑Ë’‡°¥‘ ¢÷Èπ„ππÈ”¡π— ∑Õ¥¡ª’ √¡‘ “≥ πâÕ¬°«à“∑Ë’æ∫„𧫗π∑’ˇ°‘¥®“°π”È ¡—π∑Õ¥ (Siegmann ·≈–§≥–, 1996) πÕ°®“°π’Ȭ—ß¡’√“¬ß“π ∑’Ë· ¥ß„Àâ‡ÀÁπ∂÷ߧ«“¡‡ªìπæ‘…∑Ë’‡ÀπË’¬«π”‚¥¬ “√ °—¥∑’ˉ¥â®“°πÈ”¡—π∑Õ¥´È” ‚¥¬æ∫«à“ “√ °—¥ ®“°π”È ¡—π∑Õ¥´”È ¬—∫¬—Èß°“√‡®√‘≠‡µ‘∫‚µ¢Õ߇´≈≈å ∑”„À⇴≈≈嵓¬∑È—ßπ’ȇπË◊Õß®“° “√ °—¥¡’ §ÿ≥ ¡∫—µ‘‡ÀπË’¬«π”°“√· ¥ßÕÕ°¢Õ߇Õπ‰´¡å CYP1A1 ·≈– CYP3A1 ´÷Ë߇ªìπ‡Õπ‰´¡å„π °√–∫«π°“√‡ª≈Ë’¬π “√°≈¡àÿ PAHs „πÕ¬Ÿà„π√ªŸ æ√Õâ ¡°Õà ¡–‡√ßÁ ‰¥â (Pandey, ·≈–§≥–, 2006) ¥—ßπ—Èπ„π·ßà¢Õß°“√≈¥°“√√—∫ —¡º—  “√°≈àÿ¡ PAHs ‡æ◊ËÕ≈¥‚Õ°“ °“√‡°‘¥¡–‡√Áß ®÷߇ªìπ‡√Ë◊Õß∑’Ë “¡“√∂°√–∑”‰¥â‚¥¬°“√≈¥À√◊Õ‡≈Ë’¬ß°“√√—∫ª√–∑“πÕ“À“√∑’Ë¡’°“√ªπ‡ªóôÕπ¢Õß  “√°≈ÿ¡à PAHs ‰¥â·°Õà “À“√∑ºË’ “à π°“√ª√ßÿ ¥«â ¬§«“¡√âÕπ‚¥¬°“√ªîôß ¬à“ß √¡§«π— À√◊Õ°“√∑Õ¥„π π”È ¡—π„™â´”È À≈“¬§√ßÈ— ‡Œ°‡µÕ‚√´—¬§≈‘°·Õ¡¡’π ‡Œ°‡µÕ‚√´—¬§≈‘°·Õ¡¡’π (Heterocyclic amines/HCAs) ®—¥‡ªìπ “√°àÕ¡–‡√Áß∑’Ë æ∫„πÕ“À“√Õ°’ µ«— ÀπßË÷ ∑¡Ë’ º’ ⟄À§â «“¡ π„®»°÷ …“¡“° ‡√¡Ë‘ µπâ ®“°°“√µßÈ— ¢Õâ  ß— ‡°µ ‚¥¬π°— «∑‘ ¬“»“ µ√å ™“«≠ª’Ë ÿÉπ  “¢“ Environmental Carcinogenesis §◊Õ Takashi Sugimura «“à ∂“â §«π— ®“°∫Àÿ √’Ë ¡’‚∑…µàÕ√à“ß°“¬·≈â« §«—π®“°°“√ªôî߬à“ßÕ“À“√ª√–‡¿∑‡π◊ÈÕ®–¡’§«“¡‡ªìπæ‘… ¥â«¬À√◊Õ‰¡à À≈—ß®“°∑Ë’‰¥â∑”°“√»÷°…“„πÀâÕߪؑ∫—µ‘°“√ ‚¥¬°“√√«∫√«¡ “√∑’ˉ¥â®“°§«—π ®“°°“√¬à“ߪ≈“ ·≈–∑¥ Õ∫ƒ∑∏°Ï‘ Õà °“√°≈“¬æ—π∏ÿå‚¥¬«‘∏‡’ Õ¡ å (Ames test) ·≈â« Sugimura ·≈–§≥–‰¥·â  ¥ß„Àâ ‡ÀÁπ«à“  “√∑’ˉ¥âπ’È¡’ƒ∑∏‘Ï°àÕ°“√°≈“¬æ—π∏ÿåÕ¬à“ß·√ßµàÕ‡™◊ÈÕ Salmonella typhimurium TA98 ¢Õâ ¡≈Ÿ π∂È’ °Ÿ 𔇠πÕ‡ªπì §√ßÈ— ·√°„π°“√ª√–™¡ÿ ‡√Õ◊Ë ß çThe Origin of Human Canceré „πªï §.». 1976 ∑Ë’ Cold Spring Harbor ª√–‡∑» À√—∞Õ‡¡√‘°“ °“√§âπæ∫„π§√—Èßπ’Èπ—∫‡ªìπ®ÿ¥‡√Ë‘¡µâπ∑Ë’ ”§—≠ ¢Õß°“√»÷°…“‡°Ë’¬«°—∫ “√∑’Ë¡’ƒ∑∏Ï‘‡ÀπË’¬«π”°“√°≈“¬æ—π∏åÿ ∑’ˇ°‘¥¢÷Èπ√–À«à“ß°“√ª√ÿßÕ“À“√‚¥¬ „™â§«“¡√âÕπ ‚¥¬‡©æ“–°√–∫«π°“√ªôî߬“à ßÕ“À“√ª√–‡¿∑‚ª√µπ’  “√°≈àÿ¡ HCAs ‡°‘¥¢È÷π√–À«à“ß°“√ª√ÿßÕ“À“√∑’Ë„™âÕÿ≥À¿Ÿ¡‘ Ÿß ‚¥¬°√–∫«π°“√ °“√°≈Ë—πµ—« (condensation) ·≈–°“√‡°‘¥‡ªìπ‚§√ß √â“ß«ß·À«π (cyclization) ∑Ë’Õ¬Ÿà„π√Ÿª·∫∫ ‚§√ß √â“ß∑Ë’‡ªìπ heterocyclic quanidyl ∑’Ë¡’®”π«π«ß·À«πµÈ—ß·µà 2-3 «ß·≈–¡’°≈ÿà¡Õ–¡‘‚π (exocyclic amino group) ®—∫Õ¬Ÿà∫π«ß·À«π √Ÿª∑’Ë 3 · ¥ß‚§√ß √â“ß “√ HCAs ∫“ß™π‘¥  “√°≈¡ÿà HCAs Õ“®·∫ßà ÕÕ°‰¥‡â ªπì 2 °≈ÿ¡à „À≠à (Sugimura, T., ·≈–§≥– 2004) ‰¥·â °à °Õß°“√·æ∑¬∑å “ß‡≈Õ◊ ° °√¡æ—≤π“°“√·æ∑¬å·ºπ‰∑¬·≈–°“√·æ∑¬å∑“߇≈Õ◊ °

602 µ”√“«™‘ “°“√ Õ“À“√‡æËÕ◊  ÿ¢¿“æ 1.  “√°≈à¡ÿ HCAs ∑Ë’ 1 °≈à¡ÿ π¡È’ ’§≥ÿ  ¡∫—µ∑‘ ’Ë‚¥¥‡¥àπ§Õ◊ ®– Ÿ≠‡ ¬’ ƒ∑∏‘Ï°Õà °“√°≈“¬ æ—π∏åÿ (mutagenicity) ∂â“°≈¡ÿà Õ–¡‚‘ π¿“¬„π‚§√ß √“â ß∂Ÿ°‡ª≈’ˬπ‡ªìπ°≈ÿ¡à ‰Œ¥√Õ°´≈‘ µ—«Õ¬à“ß ‡™àπ 3-amino-1,4-dimethyl-5H-pyrido[4,3-b]indole (Trp-P-1), 3-amino-1-methyl-5H-pyrido [4,3-b]indole (Trp-P-2), 2-amino-9H-pyrido[2,3-b]indole (Aαc), 2-amino-3-methyl- 9H-pyrido[2,3-b]indole (MeAαc), 2-amino-6-mehtyldipyrido[1,2-a:3û,2û-d]imidazole (Glu-P-1) ·≈– 2-aminodipyrido[1,2-a:3û,2û-d]imidazole(Glu-P-2) 2.  “√°≈ÿà¡ HCAs ∑Ë’ 2  “√°≈àÿ¡π’È®–‰¡à Ÿ≠‡ ’¬ƒ∑∏‘Ï°àÕ°“√°≈“¬æ—π∏ÿå ‡¡◊ËÕ¡’ °“√‡ª≈Ë’¬π‚§√ß √â“ß·µàÕ¬à“ß„¥ „π‡πÈ◊Õ —µ«å∑’˺à“π°√–∫«π°“√ª√ÿß‚¥¬°“√ªîô߬à“ß®–æ∫ “√  “√°≈ÿà¡ HCAs ∑’Ë 2 ¡“°°«“à  “√°≈ÿà¡ HCAs ∑’Ë 1 ®÷ßÕ“®‡√¬’ °  “√°≈ÿ¡à HCAs ∑’Ë 2 ‰¥â«“à ‡ªìπ°≈àÿ¡À≈—°¢Õß HCAs ∑’ˉ¥â√—∫§«“¡ π„®‡π◊ËÕß®“°§ÿ≥ ¡∫—µ‘¥â“πƒ∑∏‘Ï°àÕ°“√°≈“¬æ—π∏åÿ∑Ë’ ™—¥‡®π  “√°≈àÿ¡ HCAs ∑’Ë 2 ‰¥·â °à 2-amino,-3-methylimidazo[4,5-f]quinoline (IQ), 2-amino- 3, 4-dimethylimidazo[4,5-f]quinoline (MeIQ), 2-amino-3, 8-dimethylimidazo[4,5-f]quinoxaline (MEIQx), 2-amino-3,4,8-trimethylimidazo[4,5-f]quinoxaline (DiMeIQx) ·≈– 2-amino-3, 7, 8-trimethylimidazo[4,5-f]quinoxaline (7,8-DiMelQX) ‚¥¬„π°√–∫«π°“√ √â“ß “√°≈àÿ¡ HCAs ∑Ë’ 2 πÈ’æ∫«à“§√’‡Õµ‘π (creatine) À√◊Õ§√’‡Õµ‘π‘π (creatinine) ¡’∫∑∫“∑ ”§—≠„π°“√ ‡ªπì µ—«µÈß— µπâ  ”À√—∫ “√°≈àÿ¡Õ‘¡‘¥“‚´ (imidazo moieties) √Ÿª∑’Ë 3 · ¥ßµ—«Õ¬“à ß µŸ √‚§√ß √â“ß “√°≈àÿ¡ Heterocyclic amines (HCAs) (∑¡Ë’ “: Sugimura, T., ·≈–§≥–, 2004) °Õß°“√·æ∑¬å∑“߇≈Õ◊ ° °√¡æ≤— π“°“√·æ∑¬·å ºπ‰∑¬·≈–°“√·æ∑¬å∑“߇≈◊Õ°

∫∑∑Ë’ 12 603 Õ“À“√ª≈Õ¥®“° “√æ‘… 1) °“√‡ª≈Ë’¬π·ª≈ß “√°≈àÿ¡ HCAs „π√à“ß°“¬„ÀâÕ¬àŸ„π√ªŸ  “√°Õà ¡–‡√ßÁ ‡¡Õ◊Ë ‡¢“â  √àŸ “à ß°“¬ HCAs ®–∂°Ÿ ‡ª≈¬Ë’ π·ª≈ß„ÀÕâ ¬àŸ„π√ªŸ ∑¡’Ë ƒ’ ∑∏‘Ï‚¥¬ªØ°‘ √‘ ¬‘ “ N-hy- droxylation º“à π∑“ß CYP1A2 ´ßË÷ ‡À¡Õ◊ π°π— ∑ß—È „π¡π…ÿ ¬·å ≈–Àπ∑Ÿ ¥≈Õß πÕ°®“°π¬È’ ß— ¡’ CYP P450 ÕË◊πÊ ∑Ë’Õ“®¡’ à«π‡°Ë’¬«¢âÕ߉¥â·°à CYP1A1, CYP1B1 ·≈– CYP3A4 ∑Ë’∑”Àπâ“∑’Ë„πªØ‘°‘√‘¬“ ÕÕ°´‘‡¥™—π„π°“√‡ª≈’¬Ë π exocyclic primary amino group „À‡â ªìπ hydroxyl amino group ´÷Ëß®–∂Ÿ°‡ª≈’ˬπ·ª≈ßµàÕ‚¥¬‡ÕÁπ‰´¡å N(O)-acetyl-transferase (NAT) ‡°‘¥ªØ‘°‘√‘¬“°“√ √â“ß ‡Õ ‡∑Õ√å (esterification) ‡Õπ‰´¡å NAT ∑æ’Ë ∫„π¡πÿ…¬å„πª®í ®ÿ∫—π¡’ 2 √ªŸ (isozymes) §Õ◊ NAT1 ·≈– NAT2 ‚¥¬∑Ë’ NAT1 ¡’°“√· ¥ßÕÕ° «à π„À≠∑à ’ÕË «—¬«–πÕ°‡ÀπÕ◊ ®“°µ∫— ·≈– NAT2 æ∫‰¥â „πµ—∫·≈–‡´≈≈凬◊ËÕ∫ÿ≈”‰ â‡ªìπÀ≈—° „π·ßà¢Õߧ«“¡®”‡æ“–µàÕ “√°≈ÿà¡ HCAs æ∫«à“ “√°≈ÿà¡ HCAs  «à π„À≠ࡧ’ «“¡®”‡æ“–‡®“–®ßµàÕ NAT1 µ”Ë „π¢≥–∑’Ë NAT2  “¡“√∂‡√àߪذ‘ ‘√‘¬“°“√ ‡µ‘¡À¡ŸàÕ–‡´µ‘≈ (O-acetylation reaction) „Àâ·°à IQ, MeIQ ·≈– PhIP ∑Ë’Õ¬Ÿà„π√ŸªÕπÿæ—π∏å ‡ÕÁπ-‰Œ¥√Õ°´’ (N-hydroxylated derivatives) ‰¥¥â ’  “√µ—«°≈“ß∑’Ë ”§—≠§◊Õ arylnitrenium ion (R-NH+) ∑’ˇ°¥‘ ®“°ªØ°‘ √‘ ‘¬“¢Õß NAT ¡’§ÿ≥ ¡∫—µ‘‡ªìπ “√°àÕ¡–‡√Áß∑’Ë “¡“√∂ √â“ßæ—π∏–‚§«“‡≈π∑å∑’˧“√å∫Õπµ”·Àπàß∑Ë’·ª¥¢Õß ‡∫ °«— π𒠄𠓬¥’‡ÕÁπ‡Õ‰¥¥â ’ πÕ°®“°πÈ’ MeIQX ·≈– IQ ¬—ß “¡“√∂‡¢“â ®—∫°—∫‰π‚µ√‡®πµ”·Àπßà ∑Ë’ ÕߢÕ߇∫ °—«π’π‰¥â‡™àπ°—π (√Ÿª∑Ë’ 4) ∑”„À⇰‘¥°“√‡ª≈Ë’¬π·ª≈ߢÕ߇´≈≈å °“√°≈“¬æ—π∏åÿ ·≈–°“√‡°¥‘ ‡´≈≈¡å –‡√ßÁ „π‡«≈“µÕà ¡“ ®“°°“√»°÷ …“ƒ∑∏°‘Ï Õà ¡–‡√ßÁ ¢Õß “√„π°≈¡àÿ πæÈ’ ∫«“à µ”·Àπßà °“√‡°‘¥¡–‡√ßÁ ∑’Ëæ∫§Õ◊ µ—∫ ≈”‰ â„À≠à ‡µ“â π¡·≈–µàÕ¡≈°Ÿ À¡“° πÕ°®“°π’¬È ß— æ∫∑˪’ Õ¥·≈–º«‘ Àπß— ¥â«¬ IARC (International Agency for Research on Cancer) ‰¥â®—¥ “√°≈¡àÿ HCAs „ÀâÕ¬Ÿà„π  “√°àÕ¡–‡√Áߪ√–‡¿∑ 2A ‡™àπ‡¥¬’ «°π— °∫— Polycyclic aromatic hydrocarbons √ªŸ ∑’Ë 4 · ¥ß‚§√ß √â“ßÀ≈°— ¢Õß HCAs-DNA adducts ∑’ˇ°‘¥®“° IQ ·≈– PhIP ∑Ë¡’ “ : Sugimura, T., ·≈–§≥–, 2004 °Õß°“√·æ∑¬å∑“߇≈Õ◊ ° °√¡æ—≤π“°“√·æ∑¬å·ºπ‰∑¬·≈–°“√·æ∑¬å∑“߇≈Õ◊ °

604 µ”√“«™‘ “°“√ Õ“À“√‡æËÕ◊  ÿ¢¿“æ 2) °“√√∫—  —¡º —  “√°≈ÿà¡ HCAs „πÕ“À“√·≈–°“√‡°¥‘ ¡–‡√ßÁ µ—Èß·µà‡√‘Ë¡¡’°“√æ‘ Ÿ®πå«à“°√–∫«π°“√ª√ÿßÕ“À“√ª√–‡¿∑‡πÈ◊ե⫬§«“¡√âÕ𠇪ìπ  “‡Àµÿ¢Õß°“√‡°‘¥¢È÷π¢Õß “√°≈àÿ¡ HCAs °Á‰¥â¡’°“√»÷°…“µ“¡¡“Õ’°¡“°¡“¬∑’Ë∑”°“√µ√«®«—¥ ª√‘¡“≥ “√°≈ÿà¡π’È„πÕ“À“√ª√–‡¿∑µà“ßÊ ‚¥¬‡©æ“–Õ“À“√ª√–‡¿∑‡π◊ÈÕ —µ«å ‰¥â·°à ‡π◊ÈÕÀ¡Ÿ ‡π◊ÈÕ‰°à ‡π◊ÈÕª≈“ √«¡‰ª∂÷߇π◊ÈÕ«—«·≈–‡∫§Õπ ∑Ë’‰¥â√—∫§«“¡√âÕπ„π√Ÿª·∫∫°“√ªôîß ¬à“ßÀ√◊Õ∑Õ¥ ‚¥¬ “√ HCAs ∑’˵√«®æ∫‰¥â à«π„À≠à §◊Õ PhIP MelQx 4,8-DimelQX ·≈– 7,8-DiMelQx ª√‘¡“≥∑’Ëæ∫¡’§«“¡·µ°µà“߉¥âµ—Èß·µà 0-4800 π“‚π°√—¡µàÕ 100 °√—¡‡π◊ÈÕ —µ«å ¢÷ÈπÕ¬àŸ°—∫ √–¥—∫Õÿ≥À¿Ÿ¡‘∑Ë’„™â√–¬–‡«≈“∑Ë’Õ“À“√‰¥â√—∫§«“¡√âÕπ ·≈–√Ÿª·∫∫°“√ª√ÿ߇™àπ°√≥’¡’°“√À¡—° (marinating) √«à ¡¥«â ¬ æ∫«“à √–¥∫— PhIP ≈¥≈ßÕ¬“à ß™¥— ‡®π (Knize, M.G., ·≈–§≥–, 2002) ¥ß— ππ—È ª√‘¡“≥√—∫ —¡º— „π§π®÷ßÕ“®·µ°µà“ß°—π „π™à«ß√–À«à“ßπ“‚π°√—¡µàÕ«—π®π∂÷ß√–¥—∫‰¡‚§√°√—¡ µÕà «—π ¢÷ÈπÕ¬àŸ°∫— ª√‘¡“≥·≈–™π‘¥∑Ë’∫√‘‚¿§ Õ¬à“߉√°Áµ“¡ ·¡â«à“ª√‘¡“≥∑Ë’æ∫ªπ‡ªóôÕπ„πÕ“À“√∑Ë’∫√‘‚¿§·µà≈–™π‘¥‰¡à Ÿß ‡æ¬’ ßæÕ∑Ë®’ –µ√«®«—¥‰¥â ·µà°“√∫√‚‘ ¿§Õ“À“√∑’¡Ë ’ HCAs ®“°À≈“¬·À≈ßà æ√Õâ ¡°—πÕ“®∑”„Àâ√–¥∫— HCAs „π√“à ß°“¬‡æ‘¡Ë ¢÷Èπ‰¥â‡πËÕ◊ ß®“° HCAs ∂°Ÿ ¥Ÿ¥´¡÷ ®“°∑“߇¥π‘ Õ“À“√‰¥¥â ’ „π·ß৫“¡ ¡— æ—π∏å °—∫°“√‡°‘¥¡–‡√Áß ¡’√“¬ß“π®“°°“√»÷°…“¥â“π√–∫“¥«‘∑¬“À≈“¬™È‘π∑’˙Ȓ™—¥∂÷ߧ«“¡ —¡æ—π∏å √–À«à“ß°“√‡æË‘¡§«“¡‡ Ë’¬ß¢Õß¡–‡√Áß°—∫°≈àÿ¡∑Ë’√—∫ª√–∑“π‡π◊ÈÕ∑Ë’ ÿ°¡“° (well-done meat) µ—«Õ¬à“ß√“¬ß“π‚¥¬ Zheng ·≈–§≥– (Zheng, W., ·≈–§≥–, 1998) ∑’Ë· ¥ß„Àâ‡ÀÁπ∂÷ß §«“¡ ¡— æ—π∏凙ߑ ¢π“¥ (dose-response relationship) √–À«à“ß√–¥∫— §«“¡ ÿ° (doneness) ¢Õß ‡π◊ÈÕ —µ«å∑’˺à“π°“√ª√ÿߥ⫬§«“¡√âÕπ Ÿß°—∫§«“¡‡ ’ˬߢÕß°“√‡°‘¥¡–‡√Á߇µâ“π¡ √“¬ß“ππÈ’Õ∏‘∫“¬ ∂÷ß µ√’∑Ë’™Õ∫√—∫ª√–∑“π·Œ¡‡∫Õ‡°Õ√å  ‡µÁ°·≈–‡∫§Õπ∑’Ë ÿ°¡“°¡’§«“¡‡ ’ˬߢÕß°“√‡°‘¥¡–‡√Áß ‡µ“â π¡ ¡“°°«à“ µ√∑’ Ë™’ Õ∫√—∫ª√–∑“π‡πÕ◊È °ß÷Ë  ÿ° (rare À√◊Õ medium) ∂÷ß 4.6 ‡∑“à ·≈–µ—«Õ¬“à ß √“¬ß“π∑Ë’„Àâº≈§≈⓬°—𠇙àπ §π∑Ë’™Õ∫√—∫ª√–∑“π‡π◊ÈÕ∑’Ë ÿ°¡“° ¡’§«“¡‡ Ë’¬ß¢Õß°“√‡°‘¥¡–‡√Áß ≈”‰ â„À≠à·≈–∑«“√Àπ—°¡“°¢÷Èπ (Sinha, R., 1999) Õ¬à“߉√°Áµ“¡ ¬—ߧߡ’√“¬ß“π®“°π—°«‘®—¬ Õ°’ À≈“¬°≈ÿà¡∑’Ë· ¥ßº≈∑·’Ë µ°µ“à ß ‡™πà Norrish ·≈–§≥– (Norrish, A.E., 1999) · ¥ß«à“°“√ ∫√‚‘ ¿§‡π◊ÈÕ —µ«∑å ª’Ë √ßÿ  °ÿ ‰¡à ¡— æπ— ∏°å ∫— °“√‡°¥‘ ¡–‡√ÁßµÕà ¡≈Ÿ°À¡“° ‡ªπì µπâ °“√§âπæ∫ “√°≈ÿà¡ HCAs „πÕ“À“√ª√–‡¿∑‡π◊ÈÕ —µ«å∑’˺à“π°“√ª√ÿߥ⫬§«“¡ √âÕπ Ÿß ‡ªìπÕ’°°“√§âπæ∫ÀπË÷ß∑’Ë∑”„Àâπ—°«‘∑¬“»“ µ√å¡’§«“¡‡¢â“„®¡“°¢È÷π∂÷ß∑’Ë¡“¢Õß°“√‡°‘¥ ¡–‡√Áß ·≈–‰¥â¡’‚Õ°“  àߺà“𧫓¡√âŸπ’È¡“¬—ߺâŸ∫√‘‚¿§ ‡æË◊Õ„À⇰‘¥§«“¡µ√–Àπ—°„π°“√ªÑÕß°—π µπ‡Õß ‡æË◊Õ≈¥§«“¡‡ ’ˬ߰“√‡°‘¥‚√§¡–‡√Áß®“°°“√∫√‘‚¿§Õ“À“√ „π∑Ë’πÈ’°“√∫√‘‚¿§‡π◊ÈÕ —µ«å∑Ë’¡’  “√°≈ÿà¡ HCAs ªπ‡ªôóÕπ®“°°√–∫«π°“√ª√ÿß ‡ªìπ Ë‘ß∑’˧«√À≈’°‡≈’ˬßÀ√◊Õ§«√欓¬“¡≈¥ ª√¡‘ “≥°“√√∫—  —¡º— „À‡â À≈◊ÕπÕâ ¬∑Ë ’ ÿ¥ °Õß°“√·æ∑¬∑å “ß‡≈Õ◊ ° °√¡æ—≤π“°“√·æ∑¬·å ºπ‰∑¬·≈–°“√·æ∑¬å∑“߇≈Õ◊ °

∫∑∑’Ë 12 605 Õ“À“√ª≈Õ¥®“° “√æ‘… Õ–§√’≈“‰¡¥å Õ–§√’≈“‰¡¥å (acrylamide) ‡ªìπ∑’Ë√⟮—° ·≈–∂Ÿ°„™â¡“π“π„π«ß°“√Õÿµ “À°√√¡  ”À√—∫º≈‘µ “√‚æ≈’Õ–§√’≈“‰¡¥å∑’Ë„™â„π°“√º≈‘µπÈ”¥◊Ë¡ ·≈–„™â„πÕÿµ “À°√√¡∫”∫—¥π”È ‡ ’¬ √«¡∂÷ß °“√„™â§ß ¿“æ‡æË◊Õ¬÷¥¥‘π„À⇰“–°—π °àÕπÀπâ“πÈ’‡ªìπ∑’Ë∑√“∫°—π«à“‚Õ°“ °“√√—∫ —¡º—  Õ–§√’≈“‰¡¥å ”À√—∫¡πÿ…¬åπÈ—π ‡°‘¥®“°°“√√—∫ —¡º— ®“°°“√ª√–°Õ∫Õ“™’æ·≈–πÈ”¥Ë◊¡∑’Ë¡’°“√ ªπ‡ªóôÕπÕ–§√’≈“‰¡¥å Õ—π‡πË◊Õß®“°°“√„™âÕ–§√’≈“‰¡¥å„π°√–∫«π°“√º≈‘µπÈ”¥Ë◊¡  à«π°“√æ∫ °“√ªπ‡ªÕôó π¢ÕßÕ–§√≈’ “‰¡¥å „πÕ“À“√‡√¡Ë‘ ®“°°“√µ—ÈߢâÕ —߇°µ‚¥¬ Bergmark ·≈–§≥–∑µ’Ë æ’ ¡‘ æå √“¬ß“π„π ªï §.». 1997 ∂ß÷ °“√æ∫√–¥∫—  “√ª√–°Õ∫Õ–§√≈’ “‰¡¥å (acrylamide adduct) „π√–¥∫— §àÕπ¢â“ߠߟ „π§π‰¡ à Ÿ∫∫ÿÀ√Ë’ √“¬ß“πº≈°“√»÷°…“∑’§Ë ≈“â ¬°π— „πªï 2000 ‚¥¬ Tareke (Tareke, E., ·≈–§≥–, 2000) · ¥ß√–¥—∫Œ’‚¡‚°≈∫‘π∑’Ë®—∫°—∫Õ–§√’≈“‰¡¥å∑Ë’ Ÿß¢È÷π„πÀπŸ∑Ë’‰¥â√—∫Õ“À“√∑Õ¥ √“¬ß“π‡À≈“à πÈ’‰¡à‰¥√â ∫— °“√Õ∏∫‘ “¬Õ¬“à ß™¥— ‡®π∂ß÷  “‡Àµ°ÿ “√‡æ¡Ë‘ ¢π÷È ¢Õß∑ß—È  “√ª√–°Õ∫Õ–§√≈’ “‰¡¥å ·≈–√–¥—∫Õ–§√’≈“‰¡¥å‡Õß ·≈–‰¡à‰¥â√—∫§«“¡ π„®‡∑à“∑’˧«√ ®π°√–∑—Ëß„πªï 2002 ∑Ë’ Tareke ·≈–§≥– (Tareke, E., ·≈–§≥–, 2002) ‰¥âæ‘ Ÿ®πå„Àâ‡ÀÁπ«à“ Õ–§√’≈“‰¡¥å “¡“√∂‡°‘¥¢÷Èπ‰¥â„π Õ“À“√∑ºË’ “à π°“√ª√ßÿ ‚¥¬„™§â «“¡√Õâ π ‚¥¬‡©æ“–Õ¬“à ߬ßË‘ Õ“À“√ª√–‡¿∑∑ÕË’ ¥ÿ ¡‰ª¥«â ¬§“√å‚∫‰Œ‡¥√µ ‡™àπ ¡—πΩ√—Ëß∑Õ¥ ·≈–¡—πΩ√—Ëß°√Õ∫ À≈—ß®“°π—Èπ ‰¥â‡°‘¥§«“¡µ◊Ëπµ—«Õ¬à“ß¡“°„π‡√Ë◊ÕߢÕß°“√ µ√«®«¥— √–¥∫— Õ–§√≈’ “‰¡¥å ·≈– “√µÈß— µâπ¢Õß°“√‡°¥‘ Õ–§√≈’ “‰¡¥å„πÕ“À“√ª√–‡¿∑µ“à ßÊ À≈—ß°“√§âπæ∫‡°‘¥Õ–§√’≈“‰¡¥å‰¥â ‰¡àπ“ππ—° °Á¡’°≈ÿà¡π—°«‘∑¬“»“ µ√å∑Ë’æ∫«à“ Õ–§√’≈“‰¡¥å∑Ë’æ∫„πÕ“À“√ à«π„À≠à ‡°‘¥®“°ªØ‘°‘√‘¬“√–À«à“ß°≈ÿà¡Õ–¡‘‚π¢Õß°√¥Õ–¡‘‚πµ—«Àπ÷Ëß §Õ◊ ç·Õ ª“√“®π’ (asparagine)é °—∫πÈ”µ“≈„π√Ÿª¢Õß reducing sugar ∑’ËÕÿ≥À¿Ÿ¡ ‘ ߟ „π√–À«à“ß °“√Õ∫À√Õ◊ °“√∑Õ¥ ªØ°‘ √‘ ‘¬“π¡È’ ™’ ◊ËÕ‡√’¬°«“à çªØ°‘ ‘√¬‘ “‡¡≈≈“√å¥ (Maillard reaction)é ‚¥¬∑Ë—«‰ª º≈‘µ¿—≥±å®“°ªØ‘°‘√‘¬“‡¡≈≈“√奡—°∑”„À⇰‘¥√ ™“µ‘·≈– ’‡©æ“–µ—« ∑’Ëæ∫‰¥â ”À√—∫Õ“À“√Õ∫ À√◊Õªîôß „π°√–∫«π°“√¢Õߪؑ°‘√‘¬“‡¡≈≈“√å¥π’È  “¡“√∂æ∫ªØ‘°‘√‘¬“¬àÕ¬¢Õß°“√ ≈“¬µ—« ¢Õß°√¥Õ–¡‘‚π (Strecker degradation of amino acids) (√ªŸ ∑’Ë 5) ´÷ßË °√¥Õ–¡‘‚π∑Ë’À≈¥ÿ ÕÕ°¡“πÈ’ ®–∂Ÿ°µ—¥À¡Ÿà§“√å∫Õ°´’·≈–À¡ŸàÕ–¡‘‚π ∑”„Àâ‡À≈◊Õ‚§√ß √â“ß∑Ë’‡ªìπÕ—≈¥’‰Œ¥å (Mottram, D.S., ·≈– §≥–. 2002) °Õß°“√·æ∑¬∑å “ß‡≈◊Õ° °√¡æ—≤π“°“√·æ∑¬å·ºπ‰∑¬·≈–°“√·æ∑¬∑å “ß‡≈◊Õ°

606 µ”√“«™‘ “°“√ Õ“À“√‡æÕ◊Ë  ¢ÿ ¿“æ √ªŸ ∑Ë’ 5 ·ºπº—ß· ¥ß°“√ √â“ßÕ–§√’≈“‰¡¥å‚¥¬ªØ‘°‘√‘¬“‡¡≈≈“√å¥√–À«à“ß°√¥Õ–¡‘‚π·Õ ª“√“®’π·≈– °≈ÿ¡à ‰¥§“√å‚∫π≈’ (dicarbonyl group) (∑¡Ë’ “: Mottram, D.S., ·≈–§≥–. 2002) 1) °“√‡ª≈Ë’¬π·ª≈ßÕ–§√’≈“‰¡¥å„π√à“ß°“¬„ÀÕâ ¬Ÿà„π√ªŸ  “√°àÕ¡–‡√Áß Õ–§√’≈“‰¡¥å “¡“√∂∂Ÿ°¥Ÿ¥´÷¡‡¢â“‡¢â“ Ÿà√à“ß°“¬·≈–À≈—߇¢â“ Ÿà√à“ß°“¬Õ–§√’≈“‰¡¥å  “¡“√∂°√–®“¬µ—«‰ª¬—߇πÈ◊Õ‡¬Ë◊Õµà“ßÊ ‰¥â¥’ ®“°π—Èπ®–∂Ÿ°‡ª≈’ˬπ·ª≈ß„π√à“ß°“¬‚¥¬‡Õπ‰´¡å CYP2E1 ‡ªìπ 牰≈´‘¥“‰¡¥åé ´÷Ë߇ªìπ‡¡µ“∫Õ‰≈∑å„π√ŸªÕ’ªìÕ°‰´¥å (epoxide metabolite) º≈°“√ CYP2E1 µÕà °“√‡ª≈¬’Ë π·ª≈ßÕ–§√≈’ “‰¡¥å‰ª‡ªπì ‰°≈´¥‘ “‰¡¥å‰¥√â ∫— °“√¬π◊ ¬π— ®“°°“√»°÷ …“ ∑Ë’„™Àâ π∑Ÿ ’ˉ¡¡à ‡’ Õπ‰´¡å CYP2E1 æ∫«“à ‰¡ à “¡“√∂µ√«®æ∫‰°≈´¥‘ “‰¡¥å‰¥Àâ ≈ß— °“√‰¥√â ∫— Õ–§√≈’ “‰¡¥å ∑—ÈßÕ–§√’≈“‰¡¥å·≈–‰°≈´‘¥“‰¡¥å°√–®“¬µ—«‰ª¬—ßÕ«—¬«–µà“ßÊ ∑—Ë«√à“ß°“¬·≈–¡’§à“§√Ë÷ß™’«‘µ „πÀπŸª√–¡“≥ 5 ™Ë—«‚¡ß „π¢≥–∑’ËÕ–§√’≈“‰¡¥å “¡“√∂®—∫°—∫‚ª√µ’π‰¥â¥’ (‡™àπ Œ’‚¡‚°≈∫‘π ·≈–‚ª√µ“¡’π) °≈—∫®—∫°—∫¥’‡ÕÁπ‡Õ‰¥â‰¡à¥’π—° ´÷Ëßµ√ߢⓡ°—∫‰°≈´‘¥“‰¡¥å∑’Ë®—∫°—∫¥’‡ÕÁπ‡Õ‰¥â¥’ ·µ®à ∫— °∫— ‚ª√µπ’ ‰¡¥à π’ °— ®“°°“√»°÷ …“∂ß÷ °≈‰°§«“¡‡ªπì æ…‘ µÕà ®π’ ¢ÕßÕ–§√≈’ “‰¡¥·å ≈–‰°≈´¥‘ “‰¡¥å æ∫«à“Õ–§√’≈“‰¡¥å¡’§«“¡‡ªìπæ‘…µàÕ®’π∑’Ë¢π“¥ Ÿß‚¥¬°“√∑”„À⇰‘¥°“√‡ª≈’ˬπ·ª≈ß∑’Ë‚§√ß √â“ß ¥’‡ÕÁπ‡Õ∑’ËÕ“®‡°‘¥®“°°“√·µ°À—°¢Õߥ’‡ÕÁπ‡Õ∑’Ë∑”„À⇰‘¥°“√ Ÿ≠‡ ’¬À√◊Õ°“√‡√’¬ßµ—«„À¡à¢ÕßÕß§å ª√–°Õ∫¥’‡ÕÁπ‡Õ (clastogenicity) ¡“°°«à“∑Ë’®–∑”„À⇰‘¥°“√°≈“¬æ—π∏ÿå (mutation) „π¢≥–∑’Ë ‰°≈´‘¥“‰¡¥å∑”„À⇰‘¥°“√·µ°À—°¢Õß‚§√‚¡‚´¡¡“°°«à“∑Ë’®–æ∫°“√ Ÿ≠À“¬¢Õß‚§√‚¡‚´¡ (Carere, A., 2006) °Õß°“√·æ∑¬∑å “ß‡≈◊Õ° °√¡æ≤— π“°“√·æ∑¬å·ºπ‰∑¬·≈–°“√·æ∑¬å∑“߇≈Õ◊ °

∫∑∑’Ë 12 607 Õ“À“√ª≈Õ¥®“° “√æ‘… 2) °“√√—∫ —¡º— Õ–§√≈’ “‰¡¥®å “°Õ“À“√·≈–§«“¡ —¡æπ— ∏°å ∫— °“√‡°‘¥¡–‡√ßÁ Õ–§√’≈“‰¡¥åæ∫‰¥â∑Ë—«‰ª„πÕ“À“√∑’˺à“π°“√ª√ÿߥ⫬§«“¡√âÕπ Õ“À“√∑Ë’æ∫«à“¡’ ª√¡‘ “≥Õ–§√≈’ “‰¡¥§å Õà π¢“â ߠߟ ‰¥·â °¡à π— Ω√ß—Ë ∑Õ¥ (French fries) ¡π— Ω√ß—Ë ·ºπà ∑Õ¥ (potato chips) ¢π¡ªíß°√Õ∫ √«¡‰ª∂÷ߺ≈‘µ¿—≥±åºà“π°“√Õ∫°√Õ∫À≈“¬™π‘¥ Õ¬à“߉√°Áµ“¡ª√‘¡“≥∑’Ëæ∫¬—ß¡’ §«“¡·µ°µà“ß°—π‰¥â∑È—ß„πÕ“À“√µà“ß™π‘¥·≈–Õ“À“√™π‘¥‡¥’¬«°—π´÷Ëßπà“®–¢È÷π°—∫§«“¡·µ°µà“ß ¢Õß°√–∫«π°“√º≈‘µÕ“À“√‰¡à«à“®–‡ªìπÕÿ≥À¿Ÿ¡‘∑Ë’„™â ‡«≈“∑’Ë„™â ™π‘¥¢ÕßπÈ”¡—π∑Ë’„™â∑Õ¥®π∂÷ß ≈°— …≥–‚¥¬∑Ë—«‰ª¢ÕßÕ“À“√π—πÈ Ê ·µ¬à —߉¡¡à √’ “¬ß“π°“√µ√«®æ∫Õ–§√≈’ “‰¡¥å„πÕ“À“√∑Ë’‰¡à‰¥â√—∫ §«“¡√âÕπÀ√◊ÕÕ“À“√ª√–‡¿∑µâ¡ ®“°¢âÕ¡Ÿ≈Õߧ尓√Õπ“¡—¬‚≈° (World Health Organization) · ¥ß√–¥—∫°“√√—∫ —¡º— Õ–§√’≈“‰¡¥å®“°ª√‘¡“≥∑Ë’æ∫„πÕ“À“√µà“ßÊ ‚¥¬‰¥âª√–¡“≥°“√‰¥â√—∫ Õ–§√’≈“‰¡¥åÕ¬Ÿà√–À«à“ß 0.3-0.8 ‰¡‚§√°√—¡µàÕ°‘‚≈°√—¡πÈ”Àπ—°µ—«µàÕ«—π„πºŸâ„À≠àÀ√◊Õ‚¥¬‡©≈’ˬ ª√–¡“≥ 21-56 ‰¡‚§√°√¡— µÕà «π— π°— «‘∑¬“»“ µ√剥â„À§â «“¡ ”§—≠°∫— °“√»÷°…“§«“¡‡ªìπæ…‘ µÕà ®’π (genotoxicity) ¢ÕßÕ–§√’≈“‰¡¥å¡“π“π·≈–æ∫ƒ∑∏Ï‘°àÕ°“√°≈“¬æ—π∏åÿ∑’Ë™—¥‡®π¢Õ߉°≈´‘¥“‰¡¥å´÷Ë߇ªìπ‡¡µ“∫ Õ‰≈∑å¢ÕßÕ–§√’≈“‰¡¥å„π√Ÿª·∫∫°“√»÷°…“∑’Ë„™â·∫§∑’‡√’¬‡ªìπµâπ·∫∫ „π¢≥–∑Ë’°“√»÷°…“§«“¡ ‡ªìπæ‘…µàÕ®’π‚¥¬√Ÿª·∫∫ÕË◊πÊ µÈ—ß·µà·¡≈ßÀ«Ë’‰ª®π∂÷߇´≈≈å‡æ“–‡≈’Ȭ߷≈–„π —µ«å∑¥≈Õß°Áæ∫ º≈°“√»÷°…“∑’ˇªìπ‰ª„π∑‘»∑“߇¥’¬«°—π§◊ÕÕ–§√’≈“‰¡¥å∑”„À⇰‘¥§«“¡‡ ’¬À“¬µàÕæ—π∏ÿ°√√¡ Õ¬à“ß™—¥‡®π„π —µ«å∑¥≈Õßæ∫°“√°≈“¬æ—π∏åÿ·≈–¡’º≈µàÕ°“√ √â“ߥ’‡ÕÁπ‡Õ¥â«¬ (Jagerstad, M., ·≈–§≥–, 2005) IARC ‰¥®â ¥— ª√–‡¿∑¢Õß “√°Õà ¡–‡√ßÁ  ”À√∫— Õ–§√≈’ “‰¡¥Õå ¬Ÿà„πª√–‡¿∑ Group 2A (probably carcinogenic to human) ∑ß—È π’‡È π◊ËÕß®“°¬ß— ¢“¥¢âÕ¡Ÿ≈∑™Ë’ ¥— ‡®π¬π◊ ¬—π∂÷ß°“√°àÕ¡–‡√Áß „π¡πÿ…¬å∂÷ß·¡â«à“®–¡’À≈—°∞“π®“°°“√»÷°…“„π —µ«å∑¥≈Õß°Áµ“¡ °√≥’°“√§”π«≥§«“¡‡ Ë’¬ß °“√‡°‘¥¡–‡√Áß (cancer risk) „π¡πÿ…¬å¡’°“√„™â¢âÕ¡Ÿ≈∑“ß√–∫“¥«‘∑¬“‡æË◊ÕÕ∏‘∫“¬§«“¡‡ ’Ë¬ß ¥—ß°≈à“« ´÷Ëßπà“®–„À⧫“¡„°≈⇧’¬ß§«“¡‡ªìπ®√‘ß¡“°°«à“°“√„™âº≈®“°°“√»÷°…“„π —µ«å∑¥≈Õß „π¢π“¥ Ÿß ®π∂÷ßªí®®ÿ∫—π°Á¡’√“¬ß“π°“√»÷°…“∑Ë’‰¡à¡“°π—°∂÷ߧ«“¡ —¡æ—π∏å∑Ë’·∑â®√‘ß√–À«à“ß °“√‰¥â√—∫Õ–§√’≈“‰¡¥å®“°Õ“À“√°—∫°“√‡°‘¥¡–‡√Áß µ—«Õ¬à“ß√“¬ß“π‚¥¬ Mucci (Mucci, L.A., ·≈–§≥–, 2003) ∑Ë’‰¥∑â ”°“√»°÷ …“„πª√–‡∑» «‡’ ¥π‰¡æà ∫§«“¡‡ ¬’Ë ß¢Õß°“√‡°¥‘ ¡–‡√ßÁ ≈”‰ â„À≠à (large bowel cancer), ¡–‡√Áß°√–‡æ“–ªí  “«–·≈–¡–‡√Á߉µ„πºŸâ∑Ë’√—∫ª√–∑“πÕ“À“√∑’Ë¡’√–¥—∫ Õ–§√’≈“‰¡¥µå —ßÈ ·µà 30-1,200 ‰¡‚§√°√—¡µÕà °‘‚≈°√¡— πÕ°®“°πÈ’ Mucci ·≈–§≥–¬ß— ‰¥µâ æ’ ‘¡æºå ≈ ß“π∑»’Ë °÷ …“§«“¡ ¡— æπ— ∏¢å Õß°“√∫√‚‘ ¿§Õ–§√≈’ “‰¡¥®å “°Õ“À“√°∫— §«“¡‡ ¬Ë’ ߢÕß°“√‡°¥‘ ¡–‡√ßÁ ™π¥‘ µà“ßÊ Õ’°À≈“¬™È‘πß“π ‡™à𠧫“¡‡ Ë’¬ßµÕà °“√‡°‘¥¡–‡√Á߉µ (Mucci ·≈–§≥–, 2004) ·≈–§«“¡‡ ’Ë¬ß µÕà °“√‡°¥‘ ¡–‡√Áß≈”‰ â„À≠·à ≈–∑«“√Àπ°— (colorectal cancer) (Mucci, L.A., ·≈–§≥–, 2006) °Õß°“√·æ∑¬∑å “ß‡≈Õ◊ ° °√¡æ≤— π“°“√·æ∑¬å·ºπ‰∑¬·≈–°“√·æ∑¬å∑“߇≈Õ◊ °

608 µ”√“«™‘ “°“√ Õ“À“√‡æ◊ÕË  ÿ¢¿“æ ·µ√à “¬ß“π∑ßÈ— À¡¥‰¡æà ∫§«“¡ ¡— æπ— ∏å„¥Ê ∑·Ë’  ¥ß«“à °“√‰¥√â ∫— Õ–§√≈’ “‰¡¥‡å ªπì  “‡Àµ°ÿ “√‡°¥‘ ¡–‡√ßÁ „π¡πÿ…¬å §«“¡æ¬“¬“¡„π°“√Õ∏‘∫“¬ª√“°Ø°“√≥å∑’ˇ°‘¥¢÷Èπ∑’Ë·µ°µà“ß°—π√–À«à“߃∑∏Ï‘°àÕ¡–‡√Áß ¢ÕßÕ–§√’≈“‰¡¥å„π —µ«å∑¥≈Õß·≈–„π¡πÿ…¬å ∫“ß à«π‰¥â√—∫°“√Õ∏‘∫“¬„π‡™‘ß¢Õßæ‘…®≈π»“ µ√å (toxicokinetics) ¢ÕßÕ–§√≈’ “‰¡¥å ∑Ëæ’ ∫«à“ª√¡‘ “≥√—∫ —¡º— ∑Ë’·∑®â √‘ߢÕßÕ–§√≈’ “‰¡¥å ·¡â«à“®–¡’√“¬ß“πÕË◊πÊ ∑Ë’„Àâº≈°“√»÷°…“§≈⓬°—π∑’ˉ¡àæ∫§«“¡ —¡æ—π∏å°“√‡°‘¥¡–‡√Áß ®“°°“√√—∫ª√–∑“πÕ“À“√∑Ë’¡’Õ–§√’≈“‰¡¥å π—°«‘∑¬“»“ µ√嬗ߧ߉¥â∑”°“√»÷°…“‡æ‘Ë¡‡µ‘¡ Õ¬à“ßµàÕ‡π◊ËÕß„π√Ÿª·∫∫°“√»÷°…“∑Ë’µà“ßÕÕ°‰ª √«¡∂÷ß°“√¢¬“¬º≈‡æ◊ËÕ¥Ÿ§«“¡ —¡æ—π∏å°—∫ ¡–‡√Áß™π‘¥Õ◊ËπÊ ¥â«¬ ∑È—ßπ’ȇæ◊ËÕ„Àâ¢âÕ¡Ÿ≈§«“¡‡ªìπæ‘…¢ÕßÕ–§√’≈“‰¡¥å¡’§«“¡™—¥‡®π¡“°¢È÷π ·≈–  “¡“√∂π”¡“ª√–¬ÿ°µå„™â„π°“√‡ΩÑ“√–«—ߧ«“¡‡ Ë¬’ ߉¥â¥’¬ß‘Ë ¢Èπ÷ µÕà ‰ª¥â«¬  “√ª√–°Õ∫‡ÕπÁ -‰π‚µ√‚´  “√ª√–°Õ∫‡ÕπÁ ‰π‚µ√‚´ (N-Nitroso compounds) ª√–°Õ∫¥«â ¬ “√À≈“¬√Õâ ¬™π¥‘ ∑Ë’¡’‚§√ß √â“ß„π°≈ÿà¡ N-nitroso ( N=O) ‚¥¬·∫àßÕÕ°‰¥â‡ªìπ Õß°≈ÿà¡„À≠à §◊Õ ‰π‚µ√´“¡’π (nitrosamines) ∑Ë’‡°‘¥®“°ªØ‘°‘√‘¬“¢Õß “√µÈ—ßµâπ §◊Õ  “√‡Õ¡’π∑ÿµ‘¬¿Ÿ¡‘ (secondary amines; R NHR ) ∑¡Ë’ °’ ≈¡àÿ ‰¥Õ≈— §≈’ (dialkyl) Õ≈— §≈’ ‡Õ√≈’ (alkylaryl) ·≈–‰¥‡Õ√≈’ (diaryl) ‡ªπì  «à πª√–°Õ∫ 12 „π¢≥–∑’ˉπ‚µ√´“‰¡¥å (nitrosamides) ‡°‘¥®“° “√°≈ÿࡇՉ¡¥å (R1NHëCOëR2) ‰¥â·°à N-alkylamides N-alkylureas ·≈– N-alkylcarbamates ‡ªìπµâπ Õ“»—¬ªØ‘°‘√‘¬“∑“߇§¡’∑Ë’ ‡√’¬°«à“ ªØ‘°‘√‘¬“‰π‚µ√‡´™—π (nitrosation reaction) ¿“¬„µâ ¿“«–∑Ë’‡ªìπ°√¥ (√Ÿª∑’Ë 6) √ªŸ ∑Ë’ 6 · ¥ßªØ‘°√‘ ¬‘ “‰π‚µ√‡´™π— ¢Õß “√ √â“ß “√ª√–°Õ∫°≈¡àÿ ‰π‚µ√‚´ °Õß°“√·æ∑¬å∑“߇≈◊Õ° °√¡æ≤— π“°“√·æ∑¬·å ºπ‰∑¬·≈–°“√·æ∑¬å∑“߇≈Õ◊ °

∫∑∑’Ë 12 609 Õ“À“√ª≈Õ¥®“° “√æ‘…  “√µÈ—ßµâπ∑Ë’ ”§—≠¢Õß “√°≈ÿࡉπ‚µ√‚´§◊Õ ‰π‰µ√µå (nitrite, NO ) ¿“¬„µâ ¿“«– 2 °√¥„π√à“ß°“¬ (acidic condition; pH ª√–¡“≥ 2-4) ‰π‰µ√µ®å –∂Ÿ°‡ª≈ˬ’ π‡ªìπ intermediate nitrosating species (¢È—π∑’Ë 1) ®“°°“√»÷°…“„πÀ≈Õ¥∑¥≈Õßæ∫«à“ “√®”æ«° ‡™πà ‰∏‚Õ‰´¬“‡πµ (thiocyanates)  “¡“√∂‡√àߪؑ°‘√‘¬“‰π‚µ√‡´™—π¢Õß “√‡Õ¡’π‰¥âÕ¬à“ߥ’ ¢≥–∑’Ë´‘‡µ√µ (citrate) ·≈–°√¥Õ‘π∑√’¬å “¡“√∂‡√àߪؑ°‘√‘¬“‰π‚µ√‡´™—π¢Õß “√‡Õ‰¡¥å‰¥â ∑—È߉∏‚Õ‰´¬“‡πµ·≈– °√¥Õ‘π∑√’¬å æ∫‰¥â∑Ë—«‰ª„πÕ“À“√∏√√¡™“µ‘ √«¡∑È—ßÕ“®¡’°“√„™â‡ªìπ “√‡µ‘¡·µàßÕ“À“√¥â«¬ ¥ß— π—Èπ®ß÷ ®—¥‡ªπì µ«— ‡√àß°“√‡°‘¥ “√ª√–°Õ∫‰π‚µ√‚´‰¥â‡™πà °—π πÕ°‡Àπ◊Õ®“°ªØ°‘ ‘√¬‘ “‰π‚µ√‡´™π— ¿“¬„µâ ¿“«–∑Ë’‡ªìπ°√¥·≈â« ¬—ßæ∫«à“·∫§∑’‡√’¬∫“ß™π‘¥∑’ËÕ¬àŸ„π∑“߇¥‘πÕ“À“√ “¡“√∂‡√àß°“√ ‡ª≈Ë’¬π‰π‡µ√µ®“°Õ“À“√„À⇪ìπ‰π‰µ√µå‰¥â∑’Ë ¿“«–∑’˧àÕπ¢â“߇ªìπ°≈“ß (neutral condition) ‡¡Õ◊Ë °√–‡æ“–Õ“À“√ ¡’§«“¡‡ªìπ°√¥≈¥≈ß·∫§∑‡’ √¬’ ‡À≈à“πÈ’®–‡®√≠‘ ‰¥â¥¢’ π÷È ∑”„À¡â ’√–¥∫— ‰π‰µ√µå ∑Ë ’ “¡“√∂‡ª≈’ˬπ·ª≈ßµàÕ‰ª‰¥â ‡ªπì  “√°≈à¡ÿ ‰π‚µ√‚´‰¥¡â “°¢È÷π‡™πà °—π Õ¬à“߉√°Áµ“¡ ¡’√“¬ß“π∑Ë’· ¥ß∂÷ߧÿ≥ ¡∫—µ‘¢Õß “√∏√√¡™“µ‘∑’Ë¡’ƒ∑∏‘Ϭ—∫¬—Èß ªØ°‘ √‘ ‘¬“‰π‚µ√‡´™π— ‰¥·â °à «‘µ“¡‘π´’ ·≈–«‘µ“¡π‘ Õ’ ´Ëß÷ ‡ªπì  “√Õ“À“√∑æË’ ∫„πÕ“À“√∑Ë—«‰ª∑—ßÈ „π æ◊™º—°º≈‰¡â√«¡∂÷ß∏≠— æ™◊ µà“ßÊ  “√Õ“À“√‡À≈“à πȬ’ —∫¬—ßÈ ªØ°‘ √‘ ‘¬“‰π‚µ√‡´™π— À√◊Õ°≈à“«Õ’°π—¬ÀπË÷ß §◊Õ ≈¥°“√ √â“ß “√°≈ÿà¡ “√ª√–°Õ∫‰π‚µ√‚´‰¥â ‚¥¬°“√‡ª≈’ˬπ‰π‰µ√µå„À⇪ìπ‰πµ√‘°ÕÕ°‰´¥å ∑Ë’‰¡à “¡“√∂‡°‘¥ªØ‘°‘√‘¬“‰π‚µ√‡´™—πµàÕ‰ª‰¥â ¡’§«“¡ ß —¬∫“ߪ√–°“√‡°Ë’¬«°—∫°“√∫√‘‚¿§º—° „∫‡¢’¬«∑Ë’¡’‰π‡µ√µÕ¬Ÿà¡“° «à“®–‡ªìπ·À≈àß ”§—≠¢Õß “√µ—Èßµâπ„πªØ‘°‘√‘¬“‰π‚µ√‡´™—π ‡æ◊ËÕ‡°‘¥ ‡ªìπ “√ª√–°Õ∫°≈ÿࡉπ‚µ√‚´‰¥âÀ√◊Õ‰¡àπ—Èπ √“¬ß“πÀ≈“¬™È‘π· ¥ß„Àâ‡ÀÁπ«à“ ∂÷ß·¡â«à“·∫§∑’‡√’¬ „ππ”È ≈“¬®– “¡“√∂‡ª≈’ˬπ‰π‡µ√µ„À⇪ìπ‰π‰µ√µå‰¥â ·µà‡æ’¬ß·§àª√–¡“≥§√Ë÷ßÀπ÷ËߢÕߪ√‘¡“≥ ‰π‡µ√µ∑’Ë∫√‘‚¿§‡∑à“π—Èπ∑’Ë®–∂Ÿ°‡ª≈’ˬπ‡ªìπ‰π‰µ√µå‰¥â‚¥¬«‘∏’πÈ’ ·≈–πÕ°®“°π’È “√Õ“À“√∑È—ß «‘µ“¡‘π´’·≈–«‘µ“¡‘πÕ’∑Ë’¡’Õ¬Ÿà„πº—°‡À≈à“πÈ’ ∑”Àπâ“∑’ˇªìπ “√¬—∫¬È—ߪؑ°‘√‘¬“‰π‚µ√‡´™—π‰¥â ‡ªìπÕ¬à“ߥ’ °“√∫√‘‚¿§º—°„∫‡¢’¬« ®÷߉¡àπ—∫‡ªì𠓇Àµÿ¢Õß°“√√—∫ —¡º—  “√ª√–°Õ∫‰π‚µ√‚´ „π ß‘Ë ¡™’ ’«‘µ·µªà √–°“√„¥ 1) °“√√—∫ —¡º— ·≈–°“√°”®¥—  “√ª√–°Õ∫‰π‚µ√‚´ «‘∂’∑“ß°“√√—∫ —¡º—  “√ª√–°Õ∫‰π‚µ√‚´ Õ“®‡°‘¥®“°°“√ √â“ß “√ª√–°Õ∫ ‰π‚µ√‚´¿“¬„π√à“ß°“¬ºà“πªØ‘°‘√‘¬“‰π‚µ√‡´™—π¢â“ßµâπ À√◊Õ‡ªìπ°“√√—∫ —¡º— ®“°¿“¬πÕ° ‚¥¬µ√ß µ«— Õ¬“à ß√“¬ß“π‚¥¬ Tricker (Tricker, A.R., 1997) ∑«’Ë ‡‘ §√“–À·å À≈ßà √∫—  ¡— º —  “√ª√–°Õ∫ ‰π‚µ√‚´®“°æÈ◊π∞“π¢âÕ¡Ÿ≈µà“ßÊ ‰¥â· ¥ß„Àâ‡ÀÁπª√‘¡“≥√—∫ —¡º— √«¡„π¡πÿ…¬å (total human exogenous exposure) ¢Õß “√ª√–°Õ∫‰π‚µ√‚´∑Ë’ª√–¡“≥ 1.10 ‰¡‚§√‚¡≈µàÕ«—π ‚¥¬°«à“ °Õß°“√·æ∑¬∑å “ß‡≈◊Õ° °√¡æ—≤π“°“√·æ∑¬·å ºπ‰∑¬·≈–°“√·æ∑¬∑å “ß‡≈Õ◊ °

610 µ”√“«™‘ “°“√ Õ“À“√‡æËÕ◊  ¢ÿ ¿“æ √âÕ¬≈– 72 À√◊Õª√–¡“≥ 80-120 ‰¡‚§√°√—¡µàÕ«—π‡ªìπ°“√‰¥â√—∫®“°°“√∫√‘‚¿§Õ“À“√  à«π°“√‰¥â√—∫‚¥¬«‘∂’∑“ßÕ◊ËπÊ ‰¥â·°à ®“°°“√ª√–°Õ∫Õ“™’æ√âÕ¬≈– 25 °“√ Ÿ∫∫ÿÀ√Ë’√âÕ¬≈– 2 ·≈–ÕË◊πÊ Õ’°√âÕ¬≈– 1 „π¢≥–∑Ë’°“√°”®—¥ “√ª√–°Õ∫‰π‚µ√‚´∑—ÈßÀ¡¥‡ªìπ°“√°”®—¥ºà“π ∑“ßªí  “«–·≈–Õÿ®®“√–‡ªìπÀ≈—° ‚¥¬‡ªìπ°“√°”®—¥ºà“π∑“ßªí  “«–ª√–¡“≥ 1.30 ± 1.05 ‰¡‚§√‚¡≈µàÕ«—π·≈–∑“ßÕÿ®®“√–Õ¬àŸ√–À«à“ß 1.56 ± 1.56 ∂÷ß 3.17 ± 2.58 ‰¡‚§√‚¡≈µàÕ«—π ®“° ¡¥ÿ≈¡«≈√–À«à“ß°“√‰¥â√—∫®“°¿“¬πÕ° ·≈–°“√°”®—¥ÕÕ°®“°√à“ß°“¬π’È · ¥ß„Àâ‡ÀÁπ«à“ ª√–¡“≥√âÕ¬≈– 45-75 ¢Õߪ√‘¡“≥ “√ª√–°Õ∫‰π‚µ√‚´∑’Ë¡πÿ…¬å√—∫ —¡º— ∑—ÈßÀ¡¥ ‡ªìπª√‘¡“≥ ∑’‡Ë °‘¥®“°°“√ √“â ß¿“¬„π√“à ß°“¬‚¥¬º“à πªØ‘°‘√‘¬“‰π‚µ√‡´™π— 2)  “√ª√–°Õ∫‰π‚µ√‚´„πÕ“À“√·≈–°“√‡°¥‘ ¡–‡√Áß ‡πËÕ◊ ß®“° ‰π‰µ√µå®—¥‡ªπì  “√µ—Èßµâπ∑Ë’ ”§—≠µ«— ÀπË÷ߢÕß “√°≈àÿ¡‰π‚µ√‚´ ·≈–‡ªìπ  “√∑¡Ë’ °’ “√„™‡â ªπì  “√‡µ¡‘ ·µßà Õ“À“√ (food additive) „π√ªŸ ¢Õß‚´‡¥¬’ ¡‰π‰µ√µå ‚¥¬«µ— ∂ªÿ √– ß§å ‡æ◊ËÕ¬—∫¬—Èß°“√‡®√‘≠¢Õ߇™È◊Õ·∫§∑’‡√’¬ Clostidium botulinum ´Ë÷߇ªìπ‡™È◊Õ∑Ë’ √â“ß “√æ‘… √⓬·√ߪπ‡ªôóÕπ„πÕ“À“√ (√“¬≈–‡Õ¬’ ¥„πÀ—«¢Õâ  “√æ‘…‚∫∑Ÿ≈‘π—¡®“°‡™◊ÈÕ·∫§∑’‡√’¬) ®ß÷ π∫— ‰¥«â à“ °“√√—∫ª√–∑“πÕ“À“√∑Ë’¡’‰π‰µ√µå ®—¥‡ªìπÀπ∑“ßÀπ÷ËߢÕß°“√√—∫ —¡º—  “√ª√–°Õ∫‰π‚µ√‚´ µ«— Õ¬“à ßÕ“À“√∑¡Ë’ °’ “√‡µ¡‘  “√‚´‡¥¬’ ¡‰π‰µ√µå ‡™πà ‰ °â √Õ° ‡∫§Õπ °πÿ ‡™¬’ ß ª≈“ ¡â ‡ªπì µπâ ∑ß—È π’È πÕ°®“°«µ— ∂ªÿ √– ß§°å “√‡µ¡‘ ‡æÕ◊Ë ¬∫— ¬ßÈ— °“√‡®√≠‘ ¢Õ߇™ÕÈ◊ Clostidium botulinum ·≈«â  “√‚´‡¥¬’ ¡ ‰π‰µ√µå¬—ß∑”ªØ°‘ √‘ ¬‘ “°—∫Œ’‚¡‚°≈∫‘π ∑”„À‡â °‘¥ ’·≈–√ ™“µ∑‘ ’πË à“√—∫ª√–∑“π  “√°≈ÿࡉπ‚µ√´“¡’π  “√°≈ÿࡉπ‚µ√´“¡’π∑Ë’æ∫„πÕ“À“√ ·∫à߉¥âµ“¡§«“¡  “¡“√∂„π°“√°Õà ¡–‡√Á߉¥â‡ªìπ 1) °≈àÿ¡∑Ë¡’ ’ƒ∑∏°Ï‘ Õà ¡–‡√ßÁ (carcinogenic N-nitrosoamines)  “√„π°≈ÿà¡πÈ’ √–‡À¬ ‰¥â (volatile) ¡À’ ≈“¬™π¥‘ ®¥— ‡ªπì  “√¡π’ È”Àπ°— ‚¡‡≈°≈ÿ µË”·≈–¡≈’ °— …≥–‚§√ß √“â ß∑¡’Ë «’ ß·À«π ‡ªìπÕߧåª√–°Õ∫ ‡™àπ N-nitrosodimethylamine (NDMA) N-nitrosodiethylamine (NDEA) N-nitrosopyrrolidine (NPYR) ·≈– N-nitrosopiperidine (NPIP) ‡ªπì µπâ 2) °≈ÿà¡∑’ˉ¡à¡’ƒ∑∏Ï‘°àÕ¡–‡√Áß  “√„π°≈ÿà¡π’ȉ¡à√–‡À¬ (non-volatile) ·≈–®—¥ ‡ªìπ°≈àÿ¡À≈—°¢Õß “√‰π‚µ√´“¡’π ´Ë÷ß√«¡∂÷ß™π‘¥∑Ë’¡’°“√ √â“ßæ—π∏–‡ªì∫‰µ¥å°—∫ “√‰π‚µ√‚´ (N-nitrosated peptide linkage) ‡™àπ N-nitrosoproline (NPRO) ¬—߉¡à¡’√“¬ß“π∑’Ë √ÿª∂÷ß ƒ∑∏Ï‘°àÕ¡–‡√ÁߢÕß “√°≈àÿ¡‰π‚µ√‚´∑Ë’‰¡à√–‡À¬‡À≈à“πÈ’ ·µà “√‡À≈à“πÈ’Õ“®¡’∫∑∫“∑‡ªìπ “√µÈ—ßµâπ ¢Õß “√‰π‚µ√´“¡’∑Ë√’ –‡À¬‰¥â ·≈–¡ƒ’ ∑∏Ï‘°àÕ¡–‡√Áß °Õß°“√·æ∑¬å∑“߇≈◊Õ° °√¡æ—≤π“°“√·æ∑¬å·ºπ‰∑¬·≈–°“√·æ∑¬∑å “ß‡≈Õ◊ °

∫∑∑Ë’ 12 611 Õ“À“√ª≈Õ¥®“° “√æ…‘ ®“°°“√»÷°…“‚¥¬ Mitacek ·≈–§≥– (Mitacek, E.J., ·≈–§≥–, 1999) ∂÷ß √–¥—∫ “√‰π‚µ√´“¡’π„πÕ“À“√‰∑¬‡æ◊ËÕ· ¥ß§«“¡ —¡æ—π∏å°—∫°“√‡°‘¥¡–‡√Áßµ—∫µ“¡¿Ÿ¡‘¿“§ µà“ßÊ ¢Õߪ√–‡∑»‰∑¬·≈–æ∫√–¥—∫¢Õß “√‰π‚µ√´“¡’π™π‘¥√–‡À¬‰¥âÀ≈“¬™π‘¥¥â«¬°—π ‰¡à«à“ ®–‡ªπì N-nitrosodimethylamine (NDMA), N-nitrosodiethylamine (NDEA), N-nitrosopyrrolidine (NPYR) À√Õ◊ N-nitrosopiperidine (NPIP) „𵫗 Õ¬à“ßÕ“À“√ ‡™πà ª≈“ ≈‘¥ ª≈“ â¡ ª≈“‡§¡Á µ“°·Àâß √«¡∑ȗ߇µâ“‡®’Ȭ«·≈–Õ“À“√ÕË◊πÊ ‚¥¬¡’ª√‘¡“≥¡“°πâÕ¬·µ°µà“ß°—π‰ª Õ¬à“߉√°Áµ“¡ °“√»÷°…“‡æ◊ËÕµ‘¥µ“¡·≈–§«∫§ÿ¡√–¥—∫ “√ª√–°Õ∫‰π‚µ√´“¡’π„πÕ“À“√§«√¡’°“√¥”‡π‘π°“√ Õ¬à“ßµàÕ‡πÕ◊Ë ßµàÕ‰ª „π·ßàƒ∑∏‘Ï°àÕ¡–‡√ÁߢÕß “√°≈àÿ¡‰π‚µ√´“¡’πæ∫«à“¡’ºŸâ∑”°“√»÷°…“‰«â¡“°¡“¬ √“¬ß“π‡À≈à“π’ȉ¥â· ¥ß„Àâ‡ÀÁπ∂÷߃∑∏‘Ï°àÕ¡–‡√ÁߢÕß “√°≈àÿ¡π’È„πÕ«—¬«–µà“ßÊ ‰¥â·°à µ—∫, ªÕ¥, À≈Õ¥Õ“À“√, °√–‡æ“–ª í  “«–, µ∫— ÕÕà π·≈–Õ«—¬«–Õ◊πË Ê ∑—ßÈ ¬ß— æ∫ƒ∑∏Ï¥‘ ß— °≈“à «πÈ’„π —µ«Àå ≈“¬Ê  “¬æ—π∏ÿå¥â«¬ ®÷ߧàÕπ¢â“߇ªìπ∑Ë’·πà™—¥«à“ “√‰π‚µ√´“¡’π “¡“√∂°àÕ¡–‡√Áß„π¡πÿ…¬å·≈– —µ«å ∑¥≈Õß ‚¥¬°≈‰°°“√°àÕ¡–‡√Áßπ’ȇ°‘¥®“°§«“¡ “¡“√∂¢Õ߉π‚µ√´“¡’π„π°“√‡µ‘¡À¡àŸÕ—≈§’≈ À√Õ◊ °“√‡°¥‘ ªØ°‘ √‘ ¬‘ “Õ≈— §‡’ ≈™π— (alkylation) °∫— µ”·Àπßà ‡©æ“–¢Õߥ‡’ ÕπÁ ‡Õ‡∫  ¥ß— µ«— Õ¬“à ß (√ªŸ ¿“æ ∑’Ë 7 NOC-2) · ¥ß°“√®∫— °∫— ¥’‡ÕπÁ ‡Õ‡∫ ¢Õß “√‰π‚µ√´“¡’π §Õ◊ N-nitroso-dimethylamine ∑’ˇ¡◊ËÕ‡¢â“ àŸ√à“ß°“¬®–∂Ÿ°‡ª≈’ˬπ·ª≈ß‚¥¬‡ÕÁπ‰´¡å CYP450 ¿“¬„π√à“ß°“¬ºà“πªØ‘°‘√‘¬“°“√‡µ‘¡ À¡Ÿà‰Œ¥√Õ°´‘≈ (hydroxylation reaction) ®“°π—ÈπÕπÿæ—π∏å∑’ËÕ¬àŸ„π√Ÿª¢Õß·Õ≈ø“-‰Œ¥√Õ°´‘≈- ‰π‚µ√´“¡’π (α-hydroxynitrosamine) ®– ≈“¬µ—«Õ¬à“ß√«¥‡√Á«‰¥â‡ªìπ‚¡‚πÕ—≈§’≈‰π‚µ√´“¡’π (monoalkylnitrosamines), Õ—≈§’≈‰¥Õ–‚´‰Œ¥√Õ°‰´¥å (alkyldiazohydroxides) ·≈–§àŸ‰ÕÕÕπ ¢Õ߉π‚µ√‡®π  “√Õ—≈§’≈‰¥Õ–‚´‰Œ¥√Õ°‰´¥å∑Ë’‰¥â®– “¡“√∂‡¢â“®—∫°—∫°—∫‚¡‡≈°ÿ≈µà“ßÊ ‚¥¬ ªØ‘°‘√‘¬“Õ—≈§’‡≈™—π‚¥¬µ√ßÀ√◊Õ„π√Ÿª¢Õ߉¥‡Õ‚´Õ—≈‡§π (diazoalkanes) µ”·Àπà߇∫ ∑Ë’‡°‘¥ ªØ‘°‘√‘¬“¥—ß°≈“à «‰¥â¡“°‡™àπ µ”·Àπàß N-7 ·≈– O-6 ¢Õ߇∫ °«— π’π ·≈–µ”·Àπàß O-4 ¢Õ߇∫  ‰∏¡π’ °√≥°’ “√‡°¥‘ O6-alkylguanine “¡“√∂‡¢“â ®∫— §°Ÿà ∫— ‡∫ ‰∏¡π’ ‰¥·â ∑π∑°Ë’ “√‡¢“â ®∫— ‰´‚µ´π’ ∑”„Àâ ‡°¥‘ ≈—°…≥–¢Õß point mutation ·∫∫∑’‡Ë ªìπ G:C-A:T ´Ëß÷ ‡ªπì ®ÿ¥ ”§≠— ¢Õß°“√‡°¥‘ ¡–‡√ßÁ „π‡«≈“ µàÕ¡“ °Õß°“√·æ∑¬å∑“߇≈Õ◊ ° °√¡æ—≤π“°“√·æ∑¬å·ºπ‰∑¬·≈–°“√·æ∑¬∑å “ß‡≈Õ◊ °

612 µ”√“«™‘ “°“√ Õ“À“√‡æ◊ÕË  ¢ÿ ¿“æ H3C N C 3C N C N N HC H3C CH 3 3 C N NH C N N NH2 N NN √Ÿª∑’Ë 7 µ—«Õ¬à“ߪؑ°‘√‘¬“Õ—≈§’‡≈™—πµàÕ¥’‡ÕÁπ‡Õ‡∫ ‚¥¬ “√‰π‚µ√´“¡’π §◊Õ N-nitroso-dimethylamine  àߺ≈‡Àπ’ˬ«π”„À⇰‘¥°“√°≈“¬æ—π∏ÿå≈—°…≥– point mutation ‚¥¬°“√∑”ªØ‘°‘√‘¬“Õ—≈§’‡≈™—πµàÕ ‡∫ °«— ππ’ (guanine) ‰¥â‡ªπì O6-methylguanine residue √“¬ß“π∑Ë’π“à  π„®‚¥¬ Jakszyn ·≈–§≥– (Jakszyn, P., ·≈–§≥–, 2006) ‚¥¬°“√ ∑∫∑«π√“¬ß“π«‘®—¬∑Ë’¡’°“√»÷°…“∑—Èß„π√Ÿª·∫∫°“√»÷°…“·∫∫ Cohort (11 °“√»÷°…“) ·≈– Case-control (50 °“√»°÷ …“) √–À«“à ßªï §.». 1985-2005 ‡æ◊ËÕ«‡‘ §√“–À§å «“¡ —¡æ—π∏√å –À«“à ß ‰π‚µ√´“¡’π °“√∫√‘‚¿§‰π‰µ√µå·≈–°“√∫√‘‚¿§Õ“À“√µà“ßÊ (‰¥â·°à ‡πÈ◊Õ —µ«å ‡π◊ÈÕ —µ«å∑’˺à“π °√–∫«π°“√µà“ßÊ º—°·≈–ª≈“∑Ë’ºà“π°√–∫«π°“√∂πÕ¡Õ“À“√ Õ“À“√√¡§«—π·≈–°“√¥◊Ë¡‡∫’¬√å) °—∫°“√‡°‘¥¡–‡√Áß°√–‡æ“–Õ“À“√·≈–¡–‡√ÁßÀ≈Õ¥Õ“À“√ ®—¥‡ªìπµ—«Õ¬à“ß√“¬ß“π∑Ë’¡’°“√ √«∫√«¡º≈°“√»÷°…“‰«â¡“°¡“¬Õ’°™‘ÈπÀπ÷Ë߇æË◊Õ¬◊π¬—πº≈¢Õß°“√∫√‘‚¿§‰π‚µ√´“¡’πµàÕ Ë‘ß¡’™’«‘µ π—°«‘®—¬°≈àÿ¡πÈ’ ‰¥â· ¥ß¢âÕ¡Ÿ≈„Àâ‡ÀÁπÕ¬à“ß™—¥‡®π∂÷ߧ«“¡ —¡æ—π∏å√–À«à“ß°“√∫√‘‚¿§ “√ ‰π‚µ√´“¡’πÀ√◊Õ‰π‰µ√µå°—∫°“√‡°‘¥¡–‡√Áß°√–‡æ“–Õ“À“√‚¥¬‡©æ“–º≈®“°°“√»÷°…“„π√Ÿª·∫∫ Case-control „π¢≥–∑Ë’º≈®“°°“√»÷°…“·∫∫ Case-control  à«π„À≠à°Á™’È™—¥∂÷ߧ«“¡ —¡æ—π∏å √–À«à“ß°“√∫√‘‚¿§‡π◊ÈÕ —µ«å·≈–°“√∫√‘‚¿§‡πÈ◊Õ —µ«å∑’˺à“π°√–∫«π°“√µà“ßÊ °—∫°“√‡°‘¥¡–‡√Áß °Õß°“√·æ∑¬å∑“߇≈Õ◊ ° °√¡æ—≤π“°“√·æ∑¬·å ºπ‰∑¬·≈–°“√·æ∑¬å∑“߇≈Õ◊ °

∫∑∑Ë’ 12 613 Õ“À“√ª≈Õ¥®“° “√æ…‘ ∑—ßÈ  Õß™π¥‘ ‡™àπ°—π πÕ°®“°πÈ°’ “√»÷°…“·∫∫ Case-control ‡°Õ◊ ∫∑Èß— À¡¥°Á· ¥ß§«“¡ ¡— æ—π∏∑å Ë’ ™—¥‡®π√–À«à“ß°“√∫√‘‚¿§º—°·≈–ª≈“∑’˺à“π°√–∫«π°“√∂πÕ¡Õ“À“√ Õ“À“√√¡§«—π°—∫°“√‡°‘¥ ¡–‡√Áß°√–‡æ“–Õ“À“√ (µ“√“ß∑Ë’ 1) µ“√“ß∑’Ë 1 · ¥ß¿“æ√«¡°“√»°÷ …“∑“ß√–∫“¥«‘∑¬“¢Õß “√°≈ÿࡉπ‚µ√´“¡’π·≈–°“√ √∫— ª√–∑“πÕ“À“√µà“ßÊ °∫— °“√‡°¥‘ ¡–‡√Áß°√–‡æ“–Õ“À“√·≈–¡–‡√ÁßÀ≈Õ¥Õ“À“√ ¡–‡√ßÁ °√–‡æ“–Õ“À“√ ¡–‡√ßÁ À≈Õ¥Õ“À“√ °“√√∫—  ¡— º — ®“°Õ“À“√ ®”π«π√“¬ß“π°“√»°÷ …“ ®”π«π√“¬ß“π°“√»÷°…“ ‰π‰µ√µå Case- Cohort Case-control Cohort ‰π‚µ√´“¡’π control ‡πÈ◊Õ —µ«å ‡π◊ÕÈ ºà“π°√–∫«π°“√ª√ÿß 7 (5) [3] 2 (1) [0] 2 (1) [0] - ª≈“º“à π°√–∫«π°“√∂πÕ¡Õ“À“√ 5 (4) [3] 1 (0) [0] 1 (1) [0] - º—°ºà“π°√–∫«π°“√∂πÕ¡Õ“À“√ 16 (11) [2] 3 (2) [1] 18 (11) [6] 2 (1) [1] Õ“À“√√¡§«—π 14 (10) [4] 6 (2) [2] 9 (8) [5] - ÕπË◊ Ê 7 (6) [4] 5 (1) [0] 2 (2) [1] - 6 (5) [5] 3 (3) [0] 5 (2) [0] 2 (0) 3 (3) [3] - 7 (6) [1] - - - - - ∑’¡Ë “: Jakszyn, P., ·≈–§≥–, 2006 À¡“¬‡Àµÿ : µ—«‡≈¢„π‡§√◊ËÕßÀ¡“¬ ( ) À¡“¬∂ß÷ ®”π«π√“¬ß“π∑’·Ë  ¥ß§«“¡ —¡æπ— ∏凙ߑ ∫«° (positive correlation) : µ«— ‡≈¢„π‡§√Õ◊Ë ßÀ¡“¬ [ ] À¡“¬∂÷ß ®”π«π√“¬ß“π∑’Ë· ¥ßπ—¬ ”§—≠∑“ß ∂µ‘ ‘  “√°≈àÿ¡‰π‚µ√´“‰¡¥å  “√„π°≈ÿࡉπ‚µ√´“‰¡¥å‰¥â√—∫§«“¡ π„®·≈–¡’ºŸâ»÷°…“‰«â¡“° ‡™àπ°—π ¥—ßµ—«Õ¬à“ß N-nitrosoureas ´Ë÷߇°‘¥®“°ªØ‘°‘√‘¬“‰π‚µ√‡´™—π¢Õß methylurea ∑Ë’§à“ §«“¡‡ªπì °√¥ (pH) ª√–¡“≥ 2 ‰¥‡â ªìπ N-nitroso-N-methylurea ‚¥¬ª√‘¡“≥¢Õß N-nitroso- N-methylurea ∑Ë’‡°‘¥¢È÷π ¡— æ—π∏å‚¥¬µ√ß°∫— ª√‘¡“≥ “√µ—Èßµπâ methylurea ·≈–§«“¡‡¢¡â ¢πâ ¢Õß ‰π‰µ√µå „π·ßà¢Õß°“√‡ª≈’ˬπ·ª≈߇ªìπ “√°àÕ¡–‡√Áßæ∫«à“‰π‚µ√´“‰¡¥å‡°‘¥°“√‡ª≈Ë’¬π·ª≈ß ‡ªìπ “√∑’Ë¡’§ÿ≥ ¡∫—µ‘‡°‘¥ªØ‘°‘√‘¬“Õ—≈§’‡≈™—π‰¥â‡™àπ°—π ‰¥â “√∑’Ë¡’§«“¡§ßµ—«µË” ·¡â«à“ “√°≈àÿ¡ ‰π‚µ√´“‰¡¥å‰¥â√—∫§«“¡ π„®πâÕ¬°«à“ “√°≈àÿ¡‰π‚µ√´“¡’π„π·ßà°“√‡ªìπ “√°àÕ¡–‡√Áß„πÕ“À“√ °Õß°“√·æ∑¬å∑“߇≈Õ◊ ° °√¡æ≤— π“°“√·æ∑¬·å ºπ‰∑¬·≈–°“√·æ∑¬å∑“߇≈Õ◊ °