Professional Documents
Culture Documents
DIAMEL Monografia
DIAMEL Monografia
&# ##################################(
'#
##########)
(#
###########################################+
)# #############################,
*#
###############&)
+#
#######################&+
,# ##########&-
-# ###############################'&
, 1% '$)1,-' %1-+1.' +' )'+ # #'+-'+' -#4,, % ,)& *1
'%.%%,1'$)',(%'#'#$%-',:$%'',:2-$%,4-'-+)',;
+%%<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<DF:F$
#% <<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<H:B$
',(+'<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<BA$
+%.%<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<BH:H$
1#-'5%<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<G$
%-'-%-'#'<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<B$
'(#'<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<DD$
3-+-'+%%'<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<DEF$
'1$+'<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<F:F$
3-+-'#1<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<BFC$
=+%.%<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<DF:F$
=,- %<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<BE:C$
.#)+%',('<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<A:DD$
+'3#<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<A:DD$
%''#$%<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<A:BG$
,-',%+%-,%,','$.',1%)+','.2(% $'#1#+*11$%-,1
'+$ 3)'%%#< .2(% $'#1#+ , 1% )+',' %'$%'
>
?-+2,#1##,$'#1#,,'%').$5,+,1%
$-''#' ,1+- )'+ # +< %-'%'
+/% '%5#5: # '%,"' 1)+'+
%2,.'%,%/,>?,)&:4,++'##)',-+'+$%-)'+# '+-'+'
-#4,,<B
%- ,- )+',': #, $'#1#, %.'3%-, 4 '-+, $'#1#, +','#1#, *1
'%.%% +1)', +'3#' % ,1 ,-+1-1+ , 3)'%% +1%, #-+'$%.,
)+%, *1 $)#+% '%,+#$%- ,1 .2 '#( ,% #-++ ,1
,-+1-1+$'#1#+<B
-+',)-'*1,-+,*1:$,$)#+,1,-',-+)1.',:#
').$5 # ,%+ %-+$'#1#+: '$' , ',+2 % # %1-+1.' : '$'
,.$1#%-%$1%'#('4'$'%.'3%-:#$%%'#',+#,#+,:*1'$%-%
#,-+,'3.2'4*1.2%4)+'$12%#+)#(%2+#<B
%1%,-1'*12#1(#%.'3%-#%1-+1.'1,,'$.'.2(%
$'#1#+ >
?: , '$)+'( *1 # (% %.'3%- , 2' $)# ,- % H<AAA
2,: #' *1 #' $14 )'-%-< ,-', +,1#-', $1,-+% *1 #
>
?,$)+,%#4%,+)+'%,1+$4'+.2'#(4:
)'+ #' -%-': $4'+ .2 % # -+-$%-' #, %+$, *1: +- '
%+-$%-:)+'1%+#,#+,<C
)'#"#&-(#*"#" ( #%*!0$"%'#%()'%-*(&-
(- " %(' (%'(3 " #"")'#"( "#'! (3 " (-()"( #" $"
)'%-*#"#4"!% # () '%-() ( #('.# " -" ()-# ' 0#
%#' #"%$" '0 '+" ) 4 &- !#()'# (-%'#' )'%-*
-#(!" (#!* 6")'#'.*. # 5 -#(!"/'# #' 5
59973 "
#!%'$" #" -#(!" "# *. 6 #'')# 5 -#(!" 5
73 #.'
67/% #" )')!")# &-'**('%*"-"#"#(4:9
!
#&
&
"
# #
!
& "
'(&)
() "# -"# ( "(' -" $" %# -!3 / ( #!#
!#"#)'%#(###)'#(!!")#(3" )')!")# )(*%#9/:3
("'#!!)$ #/"()-#"(&-%'(")"'(()"%'' "(- "3#!#
("'#!#.'#(%# &-(*#(6
74;
#
"
#'"
" ' "!
#
!!
#
"
" !
!#"0 "
!""+"!#
"0'"!'"
"
!
"'!!
'
"
"
)
'!3"#'
''"
'
"!
!#"6'"70
"'
#
!'
3=
#
" $ : '" ' ! !
" + "
!'
+
"
3
!#
!,!
"#!'
"'"
#
""#
"
!"0
'
"!'#!"
"'0
$'
!"
"
"#!
"3
!
"#"'"0
)'+!'
"'0
#!
'"
"
'"0 '
!)
!'
0 '
'" '
!""
#"
!'
" !
!"3>
#
"
#'"$;
"'
!
#
'
#!
#
!""+!
"
<9"+"
!#
!,!"'
"
!
"'
!
$0"'
"'
'0!!
""#
"'
!!0 '
'!
!'
+'#*3#
""
"
$"
"# !
#!
"
$" +
#
"0 !
""#
"'
!!+
"3'
+
'
#0 )!$"
'
"
!
" "!
'
#
"
'3>
#
"
#'"$;"
"'+!!#+'#!
"
"!!!
" ! + !)"'!
"0 "
'!%"1
"0 '
!)!
'
!0"'
!
+'#
!"3>
"!
#
"
!#
!,!
'")'
#!
"
"
"'
#
" #!
"2 "
0
#
"
#'" $ ; #
! '"0
!#
"+"
!
"'
"3
!(
"#"
"
#
"
"
'(()!!(,!:%'!(,! ;5('5$!!(,!!#()#((
!#'05%#')!)#5, !)(,!.!(!'8G
(!'# )$# ( %, %'(!)' ! !.,#( (!#( #! ,! %(# !#' 0
)#'! ,#(8 () (!'# 5 # # 0#'5 *! .'#( # %#!!)( 0 !# (
!('#&,)##(#(( !()!%'%#'(*!,'#8E
(!'# )$# :; ( ,! )'()#'!# # %# ')'1# %#' ,! #!,!)#
)#'('(#'#.(,'5!' !)'#!#(#! ! !)#!'
'(0'(()!!(,!8E
(!'# #.'# %#&,(*# :
; ( ,! )'()#'!# )'#!# ')'1# %#'
!#.,$! '$! 0 %'!'#!( #8??5?@ /() ,! ) !!
! (
,'( #! )( ),( *%# @5 0 ( # %'## &, '(()! %''
!(,!0%'!(,! # %!()#'(#( %"!,!%%,! !)!
%)#!((
!!#8?A5?B
%'!(,! 0'(()!!(,!(#! (
# ,!( !)' ( ,'( #!
&, !)' ( ,'( (! () )'$!5
!%!!) !)((#!#((#!#8??5?D
#( (%)#( )$#( () (!'# !,0! '(()! !(,!5 #(5
!# (%(0,! 0#''(#!)#'!,#(0)( ),(*%#
@8?B5?C
%'!(,! (* , ('$! !'#! %#' #( #.'#( 0 ( !,(
(,%'''!(50(,%' %'#,$!%*#,!#'#' #!((/,(
:!(
;5#&,%'#.#,!, !)#!'$!#(
'( #$ !) *.#(8 /(# # !'$!#( #.'#( #
%'!(,! ,()'(%' ),'#(#,#(#.'#(5#' !#%&,"#(&,()(
0!#.,$!8?F5@@
-! ')#( (),#(5 %'!'#!( # 0 '(()! !(,! ( !()! !
,!)%) %'!.0%,!!,(##'!'(!(!)',)'!0))'(
! !)!)(%,')8?C5?E
! '(, !5 '(()! !(,! #!)',0 %'$! %'!'#!( #
'#!7 %#' ,! #5 !. !)'5 0 &, !(,! ( '#! #! ('$!
!#'
6 0 %#' #)'# #5 !. %''#5 , !)' ('$! #.'
!'$!#(5 !) , !)# /%'($! !
?E :!1 #' #'
!'$!#( ! ( !,( (,%'''!( #( #.'#(; 0 *. )#'# #
BC>?E8?G5@>5@?
(,!# %,()#!,)',*#'#%#'#')#'#)0((!(%"&,
#!*!!(,# %#($!## !)#(6 !##(6.) !(0)#)'%#(7
'!!88888888888888888888888888888888888888888888888888888888888888888888888888888@B6B
! D6>
#($'#888888888888888888888888888888888888888888888888888888888888888888>=
'!*!888888888888888888888888888888888888888888888888888888888888888888888888888888>D6D
,)#1!8888888888888888888888888888888888888888888888888888888888888888888C
!)#)!)##88888888888888888888888888888888888888888888888888888888>
#$#888888888888888888888888888888888888888888888888888888888888888888888888@@
/)')#'!!#88888888888888888888888888888888888888888888888888888888@AB
#, '#888888888888888888888888888888888888888888888888888888888888888888B6B
/)')#,88888888888888888888888888888888888888888888888888888888888>B?
9'!*!88888888888888888888888888888888888888888888888888888888888888888888888888@B6B
9()!8888888888888888888888888888888888888888888888888888888888888888888888888888>A6?
*%'!#($#88888888888888888888888888888888888888888888888888888888=6@@
'#/88888888888888888888888888888888888888888888888888888888888888888888888888888=6@@
!## !888888888888888888888888888888888888888888888888888888888888888=6>C
'!! ( ,! !## (# 0 ( %'!% %#')#' !)'$!# ! , !#( 0
! (8 ( # # ,! !## ( (! # #!#! !) (! ! #(
('(, !#(60&,%,('(!)*1#!$! !)!,!!*(,!)%'
(*('(!((6!#(!#!('#!)#(,)#((!#(8( %#')!)
%' !)!''(%,()! ,!#$0)'1$!('(8?@
'!!%#(,!$!(')#6 (!,''$!(# )#)'#%!0
%'#*!%#'!,%),)'0'$!!(,!%!'*8 !(* ,
('$!)#'' !)#!(,!#: ;0'$!#' #!(!*!(,!(
# #,$!6(# )#()*!0()# !(8?A
! *! .'( ,!#!( ! #'!( #6 !)' ( &, () %','(#'
#(!)*#8 ( '6 &, ! %'*% *. !) ! # %#($! #)'(
(,()!(-*(# #(%#''!(:#' ',%# #( ##!(;6(%,'!(
:(!)'#!,*1!#' $!!;0(#(#'*!(8?B6?C
& &* )$ &$%% $ $1 "$"& $'1
) %" - &$ $$2 % % "$ #) % "$ ). $
" &)-1%1")% $+ % ")$$ $!%$
%%'&%"$&%)$" 28;18<
% %&% ) %1 &* & & %&$)&)$ +$%
%)%&% -1 "$')$1
2 )&'!1 ) ' ,& % "$
#)$ ,! )$ )%1 "$"&1 " $ ! % $%
$%28;18<
%& % )
% #) ") &$$% $ &)$
- $ "$ &%2 % ) " $&& "$)$% $ ' ,& )&'!1 " &
&3#)$'- %&$)& $"$ &23%&%
& +$'3%'
$% &$!$)!3 ,!2
)& -)&& 1%& $)&'!1)" $ % ' ,&#)
-) "$ &$ $% &$ % $% $%2 % "$ "%
' ,&&-)"$ &$$$ - 1 & ,%1 %
1& 1 &! %& %1&$ &$ %2
%1)&'!
& &$ ! &$ %' ,&% +&-+&2;9
%&-' % " $&&%%&%%
" "$ &
2
" ") $)$ % %)1 #) $%)& %
"$&%2;91;:1;;
3 $'%)
"$ & %"$) & $% 2%
$1 $% %&'.'%%)&%3 $'"$'$ &$ %
%
) %%&28=18>
)!3 $')$" %"$'"$ )$1" $))$%
,&$ %
%-%" $ $% &$+% $23 $'%
& *' "$ && $ "
'2 )& $' - $1 % )'. "$
+.$ % $%% )$" 2 -) %')$ %%& ) ! - ' ) $
" $&$)$" 1
%-)$$$$%)% 28=18>
&% %%13 $'")%')$
)"&)&$"$#)$ $
$& 1") "$%&$'+!- $$%$& %
%&&%2 %&&1 %%&) % %&$ #)3 $'')- $&
! ) % %&$ % ! 3$2 $' & %
$%" %)& %+% $ $& 45-%)28=18>
$' % ) )&$$ ) )! )& $!
$ " $ "$& )1 - #) &* % $ % &$%$ %
%
$% % $% $ & % % & $%1 & %) ,! -
$! % &$ %& 4
52 $' & % )'. $)
"& &$&& %"%1 - #) &* ) " $&&
-)+& ,! %
%$% %$1 #))&)%
&$$ %"$%)%&$ $28?
()-# (-% !)$! #!
<'!*! %#' (-( %#(( )#( !*#1!)(9
)!)# ! !/-#( (!#( # # ! &-#( #! !(( (%(9 !)' #( &- (
!-!)'!(%'(#!(#!!' ((&- (2#!!-'#%+*;CI
.!#()-#9DD
<'!*!%#'('-! %#')!))#'%'#)$!!(#(
!-'#%+ (''# ! %'(#!( *(9 - !)!# %'-($! !#!-' 2
(* -!# '!'$! ( '( !'/#((; ! () ()-#9 #( )#(
(-% !)$!#!*<
<'!*!(#('/'#!.! !)!%'(#!(&-%'(!)!
.!(!)# !#9# ###';DA
%'#- ! #'!( # - !#9 ! # '(9 2 ( #'! %#' #1$!
(-!)#)'/(-!'$!)3%#'!3 (-!)#('#!(;-(#
!# # - '# 2 (-( '/#( ( ' #!) BIEI9 -!# &- # !
0! #' -$ %$)(( &- %(#'(( () -( ! %') %#' -!
)'()#'!## '(;DB
!( # $! #( ()'( # - '# )#/ !# ( # %'!
%! !)9 %'# #( ()-#( %'!#( 2 !#( ! #()'# %'#%(
!*! )#'(9 ! -!# #-#'( 2 !*%'#'*/(; (%- &- #( )#(
!*! )#'#(()!#!#!#(%#' !( #(&-!!!(/()'!(-$!
( ("( %'#! )#'( )'/( #-$! (() '#1 !)'-';
#(
#( ! () (() #!-! -! ( !-$! )'!(#$! )#'
)'!('%$!<!!.#-'9&-!1%'($!)#&-!(%'#! )#'(
=
79
<H
<B8>;DB
%'#1 # /) ! F () %'(!) ! #( !)#( ! #' )'( # %-()#(
(*!)#(:%'#1!9%'#12%'#1 !;
#&-#('!(!)-'3'-%#
-!#! # !#;
#' */9 %'#1<E<#()#9 () #' %#'
#(#'$!%'#1!;DC
-!#! # # -! #!3 %' -( !3 (; - -!$! %' ' # # #!3 !
/'(( '#!( &- ( () '#! %'!% !) #! )#( # (
%'#)!(;DC
/) ! F ). # # #!3 ! (# %#($! 2 %'#/ !)# #(
')#( '#!#9 ( '(( 2 ( %'#)!(9 2 ! %'#-$! !-'#)'!( (#'(9
(-'!# &- #( %'#(#( )$#(9 # # )#( # ( '(( 2 (
%'#)!(9-!#!!#'') !);DC
()-#
9 ! &- %'*%'#! ( HA;AAA -'(9 '/$ -!
2#' !! !' ( ( ')'( #'#!'( ! %'(#!( #! !/( (
#(/) !F!# %'$! #! %'(#!( #! !/( ( )#(; DG
!
*%
< $
$
$ #
&*$
$
(
$ %
$ $%$
#
$,(
%#
#
(
$
1 :=$
#0($(!%!#+
#$%
$%
%#
2:>
0
#0 (*$ ,
0 ,
"( $ $%&-
+
($*
% !#
%#
$2
*%
89 #"(# !
#
$(
$#
%# %#$
0 (
!#%
$
#%
!#
$
(
$!
#%
$
(
$
$%#
2::0:;
*%
89,
%$(
%
$!
#
$%$$0"(
$(*-
%
(#
$#%#
%$2
$
$
#
!
#
#
,
%%
!
2
"(
$%$$
!#!
#%
$
%#
$%$&
$$
$(
%0!#!#
#$
%#
*$
%
2::0:;
#
%0
*%
89 $
$
!#
$
0 (
#
%#-
!#
(
$ $
(
$ #
$ #
!# , !#
$-
!
(
$#*$
$2+$%*$&
$#
%$"(
$
(
,# #$
%#$
#$$ , #
$
(##
&*
$2::0:;
*%
3
$
#
4
$$%
(
%#
*$
$&(
&*
(
%
#
0
!#(
%## 0
%#
$#
$
,
!
%$2::0:;
*%
%)
(!%%
&+
%$(
(
0
$$#(
%
#(
%#0 ,
"(
%#$2;7 $0 $ ( !%% #
$
!#%
$0!#$%
(
$
$!$0
$!#%
$,0"(
%#(,
!
%$$
%$0
$
,%#
$#
$
#
$#
&*
$2;9
*%
$
*#% ( !#$
0 ,
"(
!#*
$(
0 ,
$
!
#
$ %##% $
(0
#
(
#
(
#
$
&*
%0 #
!
#%#$
$$
$(
0
!#(
,
%#
(
$
2;9
*%
0 #
$
$( !#
&+
%0 $ !#$%
%
!#%
%#
$
#
$
#$0
&#$0 #%
%$ % +
$
# %%#
*
%2
$$0 !
#
#(
# $ *$
#
#&$
(
(#! $ $%
$%#$0
#0%#
(
$$
$0#
%(#
$0"(
(#
$0%
2;9
!#$
$
#
$ $!
% #*
% $ (
%$0
$
$!
$ #
&*
$
+ 3#
$ #$4 "( $ #
(#
%
%$$ ,
&*
(%#
2 $%$ #
$ #$ $%
$
$
$ ,
$%#$
%#2::0:;
! $&'!( $&"$' !)"/!(' 0 ' '", ! ,5
! '(," &!(
"'(&"%,"'!"' &".',&'.( !!$!(''$)"'$,!
&'',!#!#/"!(&"'!('!,7
85::4:;
" '#&" ,!"! " " ,! !)"/!(4 ! .(&"4 !!" ' '$'
&).' "/!" 0 %,' &).' !(&#!" 7&' &'84 $!"'
(&"'(&"5::4:;
"!"( !" ""$!("(!"4.( ! <',!"!1 %,$&)$!
("' " !&)" 0 ! '!('' "'(&"4 "'"$"'4 "& "!' '(&"' 0
$"&&! $& ""!5 " $!("(!" '( " $,'(" $"& " $!(""
",!',,!(6!!4$"&!$$*"5;:
$"
$"
# "
# , #(# "
$"#1
#
(
"
# #&(#
#"
$"29<
#$
"($"$ $
$"*
#
#(
, +#$ (
#$"
"
#$"(
$("
,(
$"#2(!(
"
!(
#(
3-
#
$$
$
#
"
"
"
1
$
"(
%*
#(
#
#
#$"(
$("
#$
"
2#
(#1 # #( $# -
#
"
,
($
$(
(
"
"
$"1#!($
"
#(
"
1,
#
2 -
$
(
$"
#
#
#(
"
#
#
#&(#
###
$#1#"
"
2:8
#
$"
# -
# #$#
"%
# #$ "
#
#$##1
$ ,
#
"
"
#2 #1 -
"
#" ( (
"
#
$"
#(
#
#(
1 ,
"$
%"#
#
$
#
#(#
## "#!(($"$"
(
$%
#"
"
2:8
"
1$
"%1#(
"($
(,"
&
#
1,#(
#($#
$("
##"
#
$
#2
#
$
##
"
#
$
#"# #
#
"
-(
"
,
#!(
"(
$ "
%+
$2$"
#"($
#!(
#$#$(##
*
-
#1
"
#
(
# # "
#
%+
$#2 "#$
(
$ #
$ *
#4
$
#51!( " "
(
"$
$
%+
$,#
"
!(
#
$
## "
%*"# #
#
#
"
#
(2::
$"(,
"
)% # "
# $"
(%
#
(
$1
$1
%
$"
,
%+
$1$"$"
#2
(
$
"
##$(
"("##*#%
"#,
(#$("
-
"
"%
(:<#
(#!(#+$"
$##$
$
$
"
##
"#
#
#(
,
#$
-
#1
#
(
%*
$ "$
$"
2
"
4
51("
:= (#
#$(
#(
"##$
#(
1 (
"(
("$
$# ,
# #
(
#
$"
#
"
#"
$
#
$
##
(
$
$
"
#
#2
!$79 !
$
$
$
"' 1
2
$
!
!
" 6
$
$
!0 !
$! $
$
$
!
$ $ !'
$
!
$0
$! !$
$"*
"&
!!
!
%"
0
!
"/ !
$
$
!
$
!
!07:
$ ! ! ' ! $ $ ! ! $!* /
*/
!$
0
$"
$
*)
!(/
!
/) $
$)
)$
!
* '
*%
0
$
!(!
) *
!! !!
"/
$
"
$$!!
!
$ $
$
$
'
!!
"07/85
=+!3**8 *'$> * /# #/+)/-% (/ %#-# # */ %"'%*&#
%!%!"#+%*8"#%%*81+"#*82+)+%!/32+)+%)##%:
! "%-1% ') *%) *+* */*+#* / ! ')%' #-%2#+ '%!/"#+
"%*+)'%)/#!!*8+#+%
%"%
:
*+ %"'%*&# *%"- -1&# "%!/!) @8A %"% )*/!+% /# #/+)/-%
!+"#+ -1%8 3 (/ ! %'-"4 !* ')%'* +)'/-* 3 "'! !
*#)*"% #+) !!*8 #% (/
*+ #% ') +)+) *+%*
')!/"%*%)**+#!#*/!#8+/#%#!"+%!*"%!!/%*8!
14(/)/!*+)*%2-1%:
0#*+/%*)!4%*#'#+*-%*%#)**+#!#*/!#8*%+/1)%#
)*/!+%*1%)!*#!*"#/&#!%*#1!*+)!)%*3*%*)1&/#/"#+%
%!*+)%!
8*%"%!" %)!%*#*< 3<#/#')%%D
"**:B8D
/#(/+%13"/%*%#%"#+%)!*%'+%!%!
8/#%)"
)**+# ! #*/!# #+)#* ! *#)%" ') *) /# +%) "'%)+#+ # */
*))%!!%: /#% * ')*#+ # '#+* %# %*8 ! )**+# ! #*/!#
%*)1*2'!#')+'%)!2*%+ %)*%9*#")%8*%#*++%(/
#!/*% !* "/ )* !* %#
-## /# "3%) )**+# ! #*/!# #
%"')&#%#!*"/ )*%#!"*"%#"*%)'%)!*#
:CC
')#*/!#" *-"/! ! *)&# #)%# '%) !%* %1)%* 3 !* !#/!*
*/')))#!*83*/')"!')%/&#'-!!%/!# %)%)"%#**2/!*
=!#!*
>8!%(/')%1%/#/"#+%#)&#%*
!)* %!&"#+ -1%*: ! 2*% !%! #)&#%* %1)%* % !
')#*/!#"/*+)*')"+/)!%*%!/!%*%1)%*8%)"#%'(/$%*(/*+*
3#%1/!&#:CC
#+"#+8 * # )%"#% )"%* *#*!4%)* #*/!# %"% !+)#-1
+)'/-!)%'!4%#!+)+"#+%!
:!"'%)+#!')#*/!#"
# ! *))%!!% ! ')#)%#*"% 3 # ! ')+/)&# ! %!/!%#**8 ')
)4%#! */'%#) (/ *%* )"%* '/# *) 0-!* ') )*+!) !%* ')"+)%*
!#%* 3 #%)#%* !
! +#/) ! 2*% #*/!#: * # % #*3%* %#
1)**/*+#*8%"%!",%)"#8!+)%!+4%#8!)%*!+4%#8!'%!+4%#3!<
)%<#%*+%!8%#/#%*)*/!+%*:CC
'+ $&"+("+." """" +(&+)"3 "$&(&( (""'
'("'$&+"'.&''( '+ 4'3 -'('(' " '3
'$&"$+'(""""$# (&$+)$&'(' &"3.%+(, &'&
"(&"'&"'' '/"&' '+ ' "'("''+ &"'+'"'$"&"'4
Clinical Study
D i a m e l Th e r ap y i n Po l y c y s t i c O v a r y Sy n d rom e Re d u c e s
Hyperinsulinaemia, Insulin Resistance, and Hyperandrogenaemia
)+.)%)$$2:)%5"'$+$)25*"
/*)""%1.)%)):
%
)$$2:)%1%"%)*CD)"2)%$.$*+.%+)'"%%$BE'$+*%$
8
')%1+&.$$*1%"$%+)'"%$"(."*.'"#$+%$.+)%$"#";$.)%'
*%#)"2%#%#"<*%#')&%$.$'"%8
*#.!)*$)')%.,/.)%$*+).*"+%)#$+$%*).'%*@F1@G
#.!)*5)*',/#$+6))%$#"%'"%1*"*)"2&.$*.#$+%.)$+
D#**#$+/".&$"$1%(.#8
Tabla 5: Evolución del índice de resitencia a la insulina (HOMA-IR) en pacientes con síndrome
de ovario poliquístico
n Diamel n Placebo
HOMA-IR inicio 18 4,3 ± 2,4* 19 4,6 ± 2,5*
HOMA-IR 3 meses 17 2,6 ± 1,3* 16 3,3 ± 2,0*
HOMA-IR 6 meses 16 2,4 ± 1,2* 16 3,3 ± 2,1*
* p = 0,04
Datos en media ± DE
! &*#'! *'%! 7 %& & !%/ !!
83 !#*&'! #!% !!&3 ,'&3 !!'!&3 -'%'! * .
-'%'!%!3(,!'#%!&!(,"!*%3!!&,
#%(!.&'%!&'&(3#!%&%*'%(,'%#*(#%'&(#!>
7>85
4 ,*% *%' * #%!! B && !'%! '"!3 &&
&* . *" & *& ' #'& ! > '!! &
5
#!&!!*>#&*&?<*'!&'&&.*!3!.
5
!&#'&&''%!&@<.!&BA !&3.(#!,!*"
%3 '% !& < . !& =< !&5
-*." !& #'& ! !!
7=8&*#%!%=<F!!!#!& %"& !%& ! %,&5 *%! '%'!&
*%' B && ! ,*" . !$* 7&* .*&3 *!& & .
*!& #!&'#% !& !%&3 =3 !&'%!3 '%%!&3 !&'%!
9
:3
&6
.68#%#!3.!?.B&&5
(
$
"
%#
#
aQ 434*8(W 48:58,4:1D9,9
bQ @#4%!3,!4NW8@39B,!0 48:48,$9W261$#$3<(!<43PW:!+]PWadbfgFW]P
adW`dbe W$9!8,6<43P ,@9,# 81 41@<43N ,7@,#N fadF W `gVahVb`ad W b`` @836,0$ #
4@:+ 484@*+N`aggbN
cQ Q QN $: 1 T3<A,81 !<A,:D 4& W*1@!492,3$ #$8,A<A$ *,39: +$86$<! @1!$89
Z
:D6$b[,38 ,:!583$U,89:6@ 1,9+$#P$ 8@8DaihiW+?69PVV#4,Q48*Va`QaaaaV/QageeW
cgfhQaihiQ: ``gbcQC
dQ
QQQN$:1Q R<1,:D4&,2$1,36<$3:9B,:+:D6$b#, $:$92$11,:@98$!$,A,3*
!42 ,3<43:+$86DB,:+*1, $3!12,#$SA, $:41Qb``fObcZa[PbhdWbi`
eQ N
QR41$4&4C,#<A$9:8$99,3#, $<!!4261,!<439Q3$B6$896$!<A$
43341#68#,*2SQ, $:$9QaiiiOdhPaWiQ
fQ
N$:1Q,2$1994!,:$#B,:+,39@1,3484896+82!414*,!12434:+$86DQ
A,1 1$:P+?6PVVBBBQ!:1D9,9@9Q3$:V9:@#Y,2$1Q+:21Q!!$94#$1f#$*49:4#$b``f
gQ N Q Q O N Q Q 3!8$9Q 3P N Q Q O
N Q O N Q
:414*,$9:8@:@81$&@3!,431QfQ$#Q,4#$3$,84P @3 8
44*3Qb```Q6Qb`Q
hQ NQQONQ Q
,9:58,!4$:8:2$3:4#$6!,$3:$9!42#, $:$92$11,:@9Q3P
8:#4#$$3&$82*$22%#,!4W!,8@8*,!QiF$#Q,4#$3$,84P @3 8
44*3Nb``bQ6Q
cgQ
iQ N Q Q O
N Q Q 39@1,3N *1@!*43 $ #, $:$9 2$11,:@9Q 3P YYYYYYQ 8:#4 #$
(9,414*,2%#,!Qa`Q$#Q,4#$3$,84P @3 8
44*3Qb``bQ6QhbgWhd`Q
a`Q NQ
Q#$ON
QQ#$O NQ#$Q82$:8493:84642%:8,!49$9-3#842$
2$: 51,!$2#, $:$9<64bQ87Q89Q#$3#4!8,341Q$: QAQe`3Qc4@14/@3Qb``fQ
aaQ N Q $: 1QN T96$!:84 &$34=6,!4 #$1 9-3#842$ #$ 4A8,49 641,7@-.9<!49NU $A,9:
+,1$3#$ 9:$:8,!,D ,3$!414*G.NA41QgeN34QbN66QabdXacbNb`a`Q
abQ QQ$:1QNT
4B!422438$641D!D9<!4A8,$9,334821B42$33#B+:,9:+$,8
9,*3,(!3!$&48:+$&$8<1,:D4&:+$646@1<43MU 1,3,!13#4!8,3414*DNA41QcgN34QbN66QabgX
acdNaiibQ
acQ
QN $: 1QNT+$ 6:+46+D9,414*D 4& 641D!D9<! 4A8D 9D3#842$NU
1,3,!13#4!8,3414*DNA41Qf`N34QaN66QaXagNb``dQ
adQ QQN T39@1,3 8$9,9:3!$ ,3 641D!D9<! 4A8D 9D3#842$NU@88$3: 6,3,43 ,3
9:$:8,!93# D3$!414*DNA41QiN34QcN66QaicXb`aNaiigQ
aeQ QN$:1QNT41D!D9<!4A8D9D3#842$)$868$!4!,4@96@ 8!+$P43:4*$3D4&:+$14BW
,8:+B$,*+:$'$!:NU1,3,!13#4!8,3414*DNA41QeeN34QeN66QffgXfgbNb``aQ
afQ QN$:1T$&$!:9,3,39@1,38$!$6:489,*31,3*,3A,A4,3:+$641D!D9<!4A8D9D3#842$
Z[NU2$8,!34@8314&+D9,414*DNA41QbhaN34QbN66QcibXciiNb``aQ
agQ QQN $: 1 T41D!D9<! 4A8,$9 3# 994!,:$# 2$: 41,! 34821,<$9 ,3 3#,3
9@ !43<3$3:9,3B42$3NU1,3,!13#4!8,3414*DNA41QdiN34QaN66QiaXiiNaiihQ
ahQ NQQ $: 1Q R94 #$ 1 2$;482,3 $2 6!,$3:$9 !42 $1 9-#842$ #$1 4A8,4
641,7@-9<!4SQ !: %#,! 49:88,!$39$N AQdiN 3Q cN b``gQ ,96 43,A$1 $2P
+?6PVVBBBQ8$#1D!Q48*V8<!@14Q4M,#jdcddic`dQ!$994$2P`a2,Qb`aeQ
aiQ N Q Q $: 1Q R-3#842$ #49 A8,49 41,!-9<!49N -3#842$ $: 51,!N ,9!4
8#,4A9!@18 $ 4 6$1 #49 *$3:$9 $39, ,1,E#48$9 # 39@1,3SQ 87@,A49 89,1$,849 #$
3#4!8,3414*, $ $: 414*,Q 4 @14N AQ e`N 3Q bN b``fQ ,9 643-A$1
$2P+?6PVVBBBQ9!,$14Q 8V9!,$14Q6+6M9!8,6:j9!,Y8?$C:\6,#j```dWbgc`b``f```b```adQ
!$994$2P`a2,Qb`aeQ
b`Q NQ Q$:1Q @<1,E"4#$*$3:$9+,64*1,!$2,3:$934:8:2$3:4#$6!,$3:$9!42
9-3#842$#494A8,49641,!-9<!49Q$A,9:Q,4#$3$,84NAQcfN3QabNb``hQ,9643-A$1
$2P +?6PVVBBBQ&$ 89*4Q48*Q 8V9,:$VB6W!43:$3:V@614#9Vb`acV`eV$2,3Y#$E$2 84b``hW
gcaQ6#&Q!$994$2P`a/3Qb`aeQ
]\N K NN #8 .N "/*0*786 *20 "# /#916/*0 #0 #. 7+0"61/# "# 1?6*1
41.*5=+7: 1N#?*78 #A* 0 "# #"* *0 "# . #461"= *20N $A* 1K ?N_K 0N _K ][\]N
*7410+?#. #/M )<4MQQ@@@N/#"*(64)* N 1/Q4"&7Q6#461"= *10Q/6S][\]Q/6\]_N4"&N
#771#/M]`6N][\`N
]]N NNNK #8 . O+0"61/# "1 1?6*1 41.* +7: 1 # /#916/*0M 6#?*71 7#" #/
#?*"%0 *7P R1?#/61][[dR?1.^bR0E\\
]^N 0 8 6 / # " * * 0 # T 6 1 & # 7 7 * 1 0 . 1 0 1 ( 6 4 ) 7 T = 8 6 # = : . 7 T 6 ( * 0 * 0 #
U@@@N*086/#"* *0#N 1/VN
]_N K#8.N//=0#S/1"=.816B :1071&6(*0*0#*08)# 6*: ..B*..N 6
=86N][[]
0Lcb=44.\M\]\S^]
]`N K#8.N#)0*0(#66*0 *4.#71&*1 )#/*786B_#"NWN.NXMNN 6##/0NdbcS[S
b\abS_^^dS]
]aN
K N #8 .N )# &6## 6"* . *0 4B6=?8# &16/8#S.B7# *7 .1 8#" 10 (.B *0#Sb^_N
cdU^VMddaS\[[[NWN.NXM61 N8.N "N *NNNN
]bN K
N
NN=86*#08#7##64#=: N#.187QM*7168#7
6' 7K][[dN
]dN N NNK #8 . O4.* !3#7 .+0* 7 " 7=4.#/#08!1 "# S 60*:0P #?N =86N ?1.N\c
01N`/4*07#48NQ 8N][[`S)<4MQQ"AN"1*N16(Q\[N\`d[Q\_\`S`]b^][[`[[[`[[[[c
^[N
K#8.N O #8B.SS 60*:0#U.#? # 60*0#V*086#8/#081&"*#: 0#=6148)BN
.10(S8#6/K60"1/*7#"K"1=.#S.*0"K4. #1S 10861..#"78="BPN6=(7N][[]L^U_VM]]^S^\
^\N
.N.NK#8.NKO78#6#7"# *"1&=/6* 104716+7##/4. 7P#?*78b^U^V][\`
^]N KN
NK#8.N *8/*0aT6#?*718=.*C"716#7=74.* !3#7 .+0* 7N#?*78
67*.#*6"##"* *0S"#6017=4.#/#086"#
*0# 1.1(*#78#86+ *`bU][[[VN
^^N K NL #8N .NK O*8/*07 *"61771.>?#*7NP 0M .*?#*6K
NKNKN *%0 *7 =86* *10*7K
4N\\N1=.1M6?*#6K\ddcN44\d\T][^