Study of the relationship
between lipids and
lipoproteins with depression
Pedram Tabatabaei, M.A.
Bijan Gilani, Ph.D.
University of Tehran
Seyed Saeid Pournaqash Tehrani, Ph.D.
University of Tehran
Abstract
T he present study was aimed at exploring the possible
relationship between cholesterol, triglycerides,
low and high density lipoprotein levels with depression in
23 normal participants. One hundred and ninety two men were
randomly selected among those attending for general health
screening in a large industrial company as the subjects of this
research. Before having their blood sampled for determining
their blood total cholesterol, triglycerides, high density and
low density lipoprotein levels, they all completed Beck
Depression Inventory (BDI). The results revealed significant
negative correlation between cholesterol and HDL levels and
depression. Hierarchical regression confirmed these finding
and indicated that HDL level accounted further variance
in depression severity not accounted for by cholesterol,
triglycerides and LDL. In other words the results showed
that after controlling other confounding variables, cholesterol
and HDL levels had significant negative correlation with
depression. In addition they could significantly predict the
variation in depression after eliminating the effect of other
variables. Triglycerides and LDL had no significant relation
with depression. These findings expanded the previous studies
and provided additional support for the relationship between
blood serum cholesterol and HDL levels with depression.
Careful research is needed to explore the underlying nature
of these relationships
Keywords: cholesterol, triglycerides, LDL, HDL, depression
.‫ﺍﺳﺖ‬
‫ﺎﺭﺷﻨﺎﺳﻰ ﺍﺭﺷﺪ ﻣﻮﻟﻒ ﺍﻭﻝ ﺩﺭ ﺩﺍﻧﺸﮕﺎﻩ ﺗﻬﺮﺍﻥ ﺑﻪ ﺭﺍﻫﻨﻤﺎﻳﻰ ﻣﻮﻟﻒ ﺩﻭﻡ ﻭ ﻣﺸﺎﻭﺭﻩ ﻣﻮﻟﻒ ﺳﻮﻡ ﺍﺳﺘﺨﺮﺍﺝ ﺷﺪﻩ ﺍﺳﺖ‬
‫ﺑﺮﺭﺳﻲ ﺭﺍﺑﻄﻪ ﺳﻄﻮﺡ‬
‫ﭼﺮﺑﻲﻫﺎ ﻭ ﻟﻴﭙﻮﭘﺮﻭﺗﺌﻲﻫﺎﻱ‬
*
‫ﺧﻮﻥ ﺑﺎ ﺍﻓﺴﺮﺩﮔﻲ‬
‫ﭘﺪﺭﺍﻡ ﻃﺒﺎﻃﺒﺎﻳﻰ‬
‫ﻛﺎﺭﺷﻨﺎﺱ ﺍﺭﺷﺪ ﺭﻭﺍﻧﺸﻨﺎﺳﻲ‬
‫ﺩﻛﺘﺮ ﺑﻴﮋﻥ ﮔﻴﻼﻧﻰ‬
‫ﺩﺍﻧﺸﮕﺎﻩ ﺗﻬﺮﺍﻥ‬
‫ﺩﻛﺘﺮ ﺳﻌﻴﺪ ﭘﻮﺭﻧﻘﺎﺵ ﺗﻬﺮﺍﻧﻰ‬
‫ﺩﺍﻧﺸﮕﺎﻩ ﺗﻬﺮﺍﻥ‬
‫ﭼﻜﻴﺪﻩ‬
،‫ﭘﮋﻭﻫﺶ ﺣﺎﺿﺮ ﺑﻪ ﻣﻨﻈﻮﺭ ﺑﺮﺭﺳﻲ ﺭﺍﺑﻄﻪ ﺑﻴﻦ ﺳﻄﻮﺡ ﻛﻠﺴﺘﺮﻭﻝ‬
(HDL) ‫( ﻭ ﺯﻳﺎﺩ‬LDL) ‫ ﻟﻴﭙﻮﭘﺮﻭﺗﺌﻴﻦﻫﺎ ﺑﺎ ﭼﮕﺎﻟﻲ ﻛﻢ‬،‫ﺗﺮﻱﮔﻠﻴﺴﻴﺮﻳﺪ‬
‫ ﻧﻤﻮﻧﻪ ﻣﻮﺭﺩ ﻣﻄﺎﻟﻌﻪ ﺍﻳﻦ ﭘﮋﻭﻫﺶ ﻋﺒﺎﺭﺕ ﺑﻮﺩ ﺍﺯ‬.‫ﺑﺎ ﻣﻴﺰﺍﻥ ﺍﻓﺴﺮﺩﮔﻲ ﺑﻮﺩ‬
‫ ﺟﻬﺖ ﺍﻧﺪﺍﺯﻩﮔﻴﺮﻱ ﻣﻴﺰﺍﻥ ﺍﻓﺴﺮﺩﮔﻲ‬.‫ ﺳﺎﻝ‬34 ‫ ﻣﺮﺩ ﺑﺎ ﻣﻴﺎﻧﮕﻴﻦ ﺳﻨﻲ‬192
‫ ﻧﺘﺎﻳﺞ ﻣﺮﺑﻮﻁ ﺑﻪ ﺁﺯﻣﺎﻳﺶ ﺧﻮﻥ‬.‫ﺍﻓﺮﺍﺩ ﺍﺯ ﺁﺯﻣﻮﻥ ﺍﻓﺴﺮﺩﮔﻲ ﺑﻚ ﺍﺳﺘﻔﺎﺩﻩ ﺷﺪ‬
‫ﺍﻳﻦ ﺍﻓﺮﺍﺩ ﺍﺯ ﻃﺮﻳﻖ ﺁﺯﻣﺎﻳﺸﮕﺎﻩ ﻃﺒﻲ ﻭ ﺗﺸﺨﻴﺼﻲ ﺩﺭ ﺍﺧﺘﻴﺎﺭ ﻣﺤﻘﻖ ﻗﺮﺍﺭ‬
‫ ﻓﺮﺿﻴﻪﻫﺎﻱ ﻣﻄﺮﺡ ﺷﺪﻩ ﺍﺯ ﻃﺮﻳﻖ ﻣﺤﺎﺳﺒﻪ ﺿﺮﺍﻳﺐ ﻫﻤﺒﺴﺘﮕﻲ‬.‫ﮔﺮﻓﺖ‬
‫ ﺩﺭ ﻧﻬﺎﻳﺖ ﭘﺲ‬.‫ﻭ ﺭﮔﺮﺳﻴﻮﻥ ﺳﻠﺴﻠﻪ ﻣﺮﺍﺗﺒﻲ ﻣﻮﺭﺩ ﺑﺮﺭﺳﻲ ﻗﺮﺍﺭ ﮔﺮﻓﺖ‬
‫ﺍﺯ ﻛﻨﺘﺮﻝ ﺳﺎﻳﺮ ﻣﺘﻐﻴﻴﺮﻫﺎ ﺳﻄﻮﺡ ﻛﻠﺴﺘﺮﻭﻝ ﻭ ﻟﻴﭙﻮﭘﺮﻭﺗﺌﻴﻦﻫﺎ ﺑﺎ ﭼﮕﺎﻟﻲ‬
‫( ﺭﺍﺑﻄﻪ ﻣﻨﻔﻲ ﻭ ﻣﻌﻨﺎﺩﺍﺭﻱ ﺑﺎ ﻣﻴﺰﺍﻥ ﺍﻓﺴﺮﺩﮔﻲ ﺍﻓﺮﺍﺩ ﻣﻮﺭﺩ‬HDL) ‫ﺑﺎﻻ‬
‫ ﺭﺍﺑﻄﻪ ﺩﻭ ﻣﺘﻐﻴﻴﺮ ﺳﻄﻮﺡ ﺗﺮﻱﮔﻠﻴﺴﻴﺮﻳﺪ ﻭ ﻟﻴﭙﻮﭘﺮﻭﺗﺌﻴﻦ ﺑﺎ‬.‫ﺑﺮﺭﺳﻲ ﺩﺍﺷﺘﻨﺪ‬
‫ ﺩﺭ ﻣﺠﻤﻮﻉ‬.‫( ﺑﺎ ﻣﻴﺰﺍﻥ ﺍﻓﺴﺮﺩﮔﻲ ﺍﻓﺮﺍﺩ ﻣﻌﻨﺎﺩﺍﺭ ﻧﺒﻮﺩ‬LDL) ‫ﭼﮕﺎﻟﻲ ﻛﻢ‬
‫ﺍﻳﻦ ﭘﮋﻭﻫﺶ ﺭﺍﺑﻄﻪ ﺑﻴﻦ ﺩﻭ ﻣﺘﻐﻴﺮ ﺳﻄﻮﺡ ﻛﻠﺴﺘﺮﻭﻝ ﺧﻮﻥ ﻭ ﻟﻴﭙﻮﭘﺮﻭﺗﺌﻴﻦ‬
‫( ﺭﺍ ﺑﺎ ﻣﻴﺰﺍﻥ ﺍﻓﺴﺮﺩﮔﻲ ﻣﻮﺭﺩ ﺗﺎﻳﻴﺪ ﻗﺮﺍﺭ ﻣﻲﺩﻫﺪ ﻭ‬HDL) ‫ﺑﺎ ﭼﮕﺎﻟﻲ ﺑﺎﻻ‬
‫ﺑﺮ ﺿﺮﻭﺭﺕ ﺗﺪﻭﻳﻦ ﻭ ﺍﺟﺮﺍﻱ ﭘﮋﻭﻫﺶﻫﺎﻱ ﺩﻗﻴﻖﺗﺮ ﻭ ﺍﺳﺘﻔﺎﺩﻩ ﺍﺯ ﺷﻴﻮﻩﻫﺎﻱ‬
.‫ﺁﺯﻣﺎﻳﺸﻲ ﺟﻬﺖ ﺑﺮﺭﺳﻲ ﻣﺎﻫﻴﺖ ﺍﻳﻦ ﺭﺍﺑﻄﻪ ﺗﺎﻛﻴﺪ ﻣﻲﻧﻤﺎﻳﺪ‬
‫ ﻟﻴﭙﻮﭘﺮﻭﺗﺌﻴﻦ ﺑﺎ ﭼﮕﺎﻟﻰ ﻛﻢ‬، ‫ ﺗﺮﻯﮔﻠﻴﺴﻴﺮﻳﺪﻫﺎ‬،‫ ﻛﻠﺴﺘﺮﻭﻝ‬:‫ﻭﺍژﻩﻫﺎﻯ ﻛﻠﻴﺪﻯ‬
(LDH) ‫( ﻭ ﻟﻴﭙﻮﭘﺮﻭﺗﺌﻴﻦ ﺑﺎ ﭼﮕﺎﻟﻰ ﺯﻳﺎﺩ‬LDL)
‫ ﺍﻳﻦ ﻣﻘﺎﻟﻪ ﺍﺯ ﭘﺎﻳﺎﻥﻧﺎﻣﻪ ﻛﻛﺎﺭﺷﻨﺎﺳﻰ‬-*
 ‫ﺑﺮﺭﺳﻰ ﺭﺍﺑﻄﻪ ﺳﻄﻮﺡ ﭼﺮﺑﻲﻫﺎ ﻭ ﻟﻴﭙﻮﭘﺮﻭﺗﺌﻲﻫﺎﻱ ﺧﻮﻥ ﺑﺎ ﺍﻓﺴﺮﺩﮔﻲ‬

‫ﺩﺭ ﺍﺛﺮ ﺧﻮﺩﻛﺸﻲ ﻭ ﺗﺼﺎﺩﻓﺎﺕ ﻣﻲﭘﺮﺩﺍﺧﺘﻨﺪ )ﺟﺎﻛﻮﺏ‪ ،‬ﺑﻠﻜﺒﻮﻡ‪ ،‬ﻫﺎﻳﺠﻴﻦ‪ ،‬ﺭﻳﺪ‪،‬‬

‫ﺍﻳﺰﻭ‪ ،‬ﻣﻜﻤﻴﻼﻥ‪ ،‬ﻧﻴﻮﺗﻦ‪ ،‬ﻧﻠﺴﻮﻥ‪ ،‬ﭘﻮﺗﺮ ﻭ ﺭﻳﻔﻜﺎﻳﻨﺪ‪1992 ،‬؛ ﻧﻴﻮﺗﻦ‪ ،‬ﺑﻠﻚ ﺑﺮﻥ‪،‬‬
‫ﺟﺎﻛﻮﺏ‪ ،‬ﻛﻮﻟﺮ‪ ،‬ﻟﻰ‪ ،‬ﺷﺮﻭﻳﻦ‪ ،‬ﺷﻴﻦ ﻭ ﻭﻧﻮﺭﺙ‪ .(1992،‬ﺑﺎ ﮔﺬﺷﺖ ﺯﻣﺎﻥ ﻣﺤﻘﻘﻴﻦ‬
‫ﺑﻪ ﺻﻮﺭﺕ ﺟﺰﺋﻲﺗﺮ ﺑﻪ ﺑﺮﺭﺳﻲ ﺭﺍﺑﻄﻪ ﻣﻴﺎﻥ ﻣﻴﺰﺍﻥ ﻣﺒﺎﺩﺭﺕ ﺑﻪ ﺧﻮﺩﻛﺸﻲ ﻭ‬
‫ﺳﻄﻮﺡ ﭼﺮﺑﻲ ﺧﻮﻥ ﭘﺮﺩﺍﺧﺘﻨﺪ )ﺁﺗﻤﺎﺳﺎ‪ ،‬ﻛﻮﻟﮕﻮ‪ ،‬ﺗﺰﻛﺎﻥ‪ ،‬ﺍﻭﺳﺘﻮﻧﺪﺍگ‪ ،‬ﮔﺴﻴﺴﻰ ﻭ‬ ‫ﻣﻘﺪﻣﻪ‬
‫‪1999‬؛ ﺯﻭﺭﻳﺦ‪،‬‬
‫ﻓﻴﺮﻳﺪﻳﻦ‪2002 ،‬؛ ﭘﺎﺭﺗﻮﻧﻦ‪ ،‬ﻫﺎﻭﻛﺎ‪ ،‬ﻭﻳﺮﺗﺎﻣﻮ‪ ،‬ﺍﻳﻠﻮﺭ ﻭ ﻻﻧﻜﻮﻳﺴﺖ‪1999 ،‬‬ ‫ﺟﻤﻌﻴﺖ ﺑﻴﻤﺎﺭﺍﻥ ﻣﺒﺘﻼ ﺑﻪ ﻧﺎﺭﺍﺣﺘﻰﻫﺎﻯ ﻗﻠﺒﻰ‪ -‬ﻋﺮﻭﻗﻰ‪ 1‬ﺩﺭ ﺟﻮﺍﻣﻊ ﻣﺨﺘﻠﻒ ﺑﻪ‬
‫ﻛﻮﺭﺑﻦ ﻭ ﺩﻭﺳﻴﻤﺘﻴﺮ‪1996 ،‬؛ ﻛﺎﭘﻼﻥ‪ ،‬ﻣﻮﻟﺪﻭﻡ ‪ ،‬ﻣﺎﻧﻮﻙ ﻭ ﻣﺎﻥ‪1997 ،‬؛ ﻛﻴﻢ‪،‬‬ ‫ﻋﻨﻮﺍﻥ ﻳﻜﻰ ﺍﺯ ﻋﻠﻞ ﺍﺻﻠﻰ ﻣﺮگ ﻭ ﻣﻴﺮ ﻭ ﺍﻓﺰﺍﻳﺶ ﻫﺰﻳﻨﻪﺍﻯ ﺣﻔﻆ ﺳﻼﻣﺖ ﺭﻭ ﺑﻪ‬
‫ﻟﻰ‪ ،‬ﻛﻴﻢ‪ ،‬ﻳﻮﻥ‪ ،‬ﭼﻮﻳﻰ ﻭ ﻟﻰ‪2002 ،‬؛ ﮔﻮﻟﻮﻣﺐ‪ ،‬ﺍﺳﺘﺎﺗﻴﻦ ﻭ ﻣﺪﻧﻴﻚ‪2000 ،‬؛‬ ‫ﺍﻓﺰﺍﻳﺶ ﻣﻰﺑﺎﺷﺪ‪ .‬ﻫﻤﺰﻣﺎﻥ ﺑﺎ ﻣﺸﺨﺺ ﺷﺪﻥ ﻧﻘﺶ ﻭ ﺍﻫﻤﻴﺖ ﭼﺮﺑﻰﻫﺎﻯ ﺧﻮﻥ‬
‫‪1992‬؛ ﻣﻮﻟﺪﻭﻡ‪ ،‬ﻣﺎﻧﻮﻙ ﻭ ﻣﺎﺗﺌﻮ‪.(1990 ،‬‬
‫ﻟﻴﻨﺪﺑﺮگ‪ ،‬ﺭﺍﺳﺘﻢ‪ ،‬ﮔﻮﻟﺒﺮگ ﻭ ﺍﻛﻮﻻﻧﺪ‪1992 ،‬‬ ‫ﻋﺮﻭﻗﻰ(؛ ﻃﻰ ﺩﻭ‬
‫ﺩﺭ ﺷﻜﻞﮔﻴﺮﻯ ﺍﻳﻦ ﺩﺳﺘﻪ ﺍﺯ ﺑﻴﻤﺎﺭﻱﻫﺎ ))ﺑﻴﻤﺎﺭﻯﻫﺎﻯ ﻗﻠﺒﻰ‪ -‬ﻋﺮﻭﻗﻰ‬
‫ﺑﻪ ﻋﻨﻮﺍﻥ ﻧﻤﻮﻧﻪ ﻣﻮﻟﺪﻡ‪ ،‬ﻣﺎﻧﻮﻙ ﻭ ﻣﺎﺗﺌﻮ)‪ (1990‬ﺩﺭ ﻣﻄﺎﻟﻌﻪﺍﻯ ﻓﺮﺍﭘﺮﺩﺍﺯﺷﻰ‬ ‫ﺩﻫﻪ ﮔﺬﺷﺘﻪ ﺗﺎﻛﻴﺪﻫﺎ ﻫﻤﻮﺍﺭﻩ ﺑﺮﻣﻀﺮ ﺑﻮﺩﻥ ﻛﻠﺴﺘﺮﻭﻝ ﻭ ﭼﺮﺑﻰﻫﺎﻯ ﺧﻮﻥ ﻭ‬
‫ﮔﺰﺍﺭﺵ ﻧﻤﻮﺩﻧﺪ ﻛﻪ ﺩﺭﻣﺎﻥﻫﺎﻯ ﻛﺎﻫﺶ ﺩﻫﻨﺪﻩ ﻛﻠﺴﺘﺮﻭﻝ‪ 4‬ﺧﻮﻥ ﺗﻨﻬﺎ ﺑﺎﻋﺚ‬ ‫ﺗﻮﺻﻴﻪ ﺑﺮﻛﺎﺳﺘﻦﺷﺎﻥ ﺑﻮﺩﻩ ﺍﺳﺖ‪ .‬ﺩﺭ ﺍﻳﻦ ﺭﺍﺳﺘﺎ ﺑﺮﻧﺎﻣﻪﻫﺎﻯ ﻛﺎﻫﺶ ﻛﻠﺴﺘﺮﻭﻝ‬
‫ﻛﺎﻫﺶ ﻣﺮگ ﻭ ﻣﻴﺮﻧﺎﺷﻰ ﺍﺯ ﻋﺎﺭﺿﻪﻫﺎﻯ ﻗﻠﺒﻰ‪ -‬ﻋﺮﻭﻗﻰ ﺷﺪﻩ ﻭ ﺗﺎﺛﻴﺮﻯ ﺑﺮ‬ ‫ﻣﺘﻌﺪﺩﻯ ﺑﻪ ﺍﺟﺮﺍ ﺩﺭﺁﻣﺪﻧﺪ ﻭ ﻣﺘﻌﺎﻗﺐ ﺁﻥ ﺳﻬﻢ ﻋﻤﺪﻩﺍﻯ ﺍﺯ ﻣﺪﺍﺧﻼﺕ ﺑﺎﻟﻴﻨﻰ ﻭ‬
‫ﻧﺮﺥ ﻛﻠﻰ ﻣﺮگ ﻭ ﻣﻴﺮ ﻧﺪﺍﺷﺘﻨﺪ‪ ،‬ﺯﻳﺮﺍ ﻛﺎﻫﺶ ﻛﻠﺴﺘﺮﻭﻝ ﺍﺯ ﺳﻮﻯ ﺩﻳﮕﺮ ﻣﻮﺟﺐ‬ ‫ﺳﻴﺎﺳﺖ ﮔﺰﺍﺭﻯﻫﺎﻯ ﺟﻤﻌﻴﺘﻰ ﻫﻢ ﺩﺭ ﻏﺎﻟﺐ ﻣﺪﺍﺧﻼﺕ ﺩﺭﻣﺎﻧﻰ ﻭ ﻫﻢ ﻣﺪﺍﺧﻼﺕ‬
‫ﺍﻓﺰﺍﻳﺶ ﻣﺮگ ﺩﺭ ﺍﺛﺮ ﺧﻮﺩﻛﺸﻰ ﻭ ﺧﺸﻮﻧﺖ ﮔﺮﺩﻳﺪﻩ ﺑﻮﺩ‪ .‬ﺍﻟﺒﺘﻪ ﻻﺯﻡ ﺑﻪ ﺫﻛﺮ ﺍﺳﺖ‬ ‫ﭘﻴﺶﮔﻴﺮﺍﻧﻪ ﺩﺭ ﺟﻬﺖ ﻛﺎﻫﺶ ﻛﻠﺴﺘﺮﻭﻝ ﺧﻮﻥ ﺳﻮﻕ ﻳﺎﻓﺘﻨﺪ‪ .‬ﺍﺯ ﺳﻮﺋﻰ ﺩﻳﮕﺮ‬
‫ﻛﻪ ﺭﺍﺑﻄﻪ ﻣﻴﺎﻥ ﺳﻄﻮﺡ ﭘﺎﻳﻴﻦ ﻛﻠﺴﺘﺮﻭﻝ ﺧﻮﻥ ﻭ ﺧﻮﺩﻛﺸﻰ ﭘﻴﺸﺘﺮ ﺩﺭ ﻣﻄﺎﻟﻌﺎﺕ‬ ‫ﺗﻮﺟﻪ ﺑﻪ ﺍﻳﻦ ﻧﻜﺘﻪ ﻧﻴﺰ ﺿﺮﻭﺭﺕ ﺩﺍﺭﺩ ﻛﻪ ﺍﻳﻦ ﺩﺳﺘﻪ ﺍﺯ ﻣﻮﻟﻜﻮﻝﻫﺎﻱ ﺑﻴﻮﺷﻴﻤﺎﻳﻲ‬
‫ﻫﻤﻪﮔﻴﺮ ﺷﻨﺎﺧﺘﻰ ﻣﻮﺭﺩ ﺗﺎﻳﻴﺪ ﻣﺤﻘﻘﻴﻦ ﻗﺮﺍﺭ ﮔﺮﻓﺘﻪ ﺑﻮﺩ ))ﺍﻟﻴﺴﻮﻥ ﻭ ﻣﻮﺭﻳﺴﻮﻥ‪،‬‬ ‫ﺑﻪ ﻭﺍﺳﻄﻪ ﻧﻘﺸﻲ ﻛﻪ ﺩﺭ ﺳﺎﺧﺘﻤﺎﻥ ﻏﺸﺎﺋﻲ ﺳﻠﻮﻝﻫﺎﻱ ﻋﺼﺒﻲ ﺑﻪ ﻋﻬﺪﻩ ﺩﺍﺭﻧﺪ‬
‫‪ 2001‬ﻭ ﺯﻭﺭﻳﺦ‪ ،‬ﻛﻮﺭﺑﻦ ﻭ ﺩﻭﺳﻴﻤﺘﻴﺮ‪ .(1996 ،‬ﺍﺯ ﻃﺮﻑ ﺩﻳﮕﺮ ﻧﻈﺮ ﺑﻪ ﺍﻫﻤﻴﺖ‬ ‫ﺍﺯ ﻧﻘﺶ ﻭ ﻛﻨﺸﻲ ﺣﻴﺎﺗﻲ ﺩﺭ ﻓﻌﺎﻟﻴﺖﻫﺎﻱ ﻣﻐﺰﻱ ﺑﺮﺧﻮﺭﺩﺍﺭ ﻣﻲﺑﺎﺷﻨﺪ ﺑﻪ ﻃﻮﺭﻳﻜﻪ‬
‫ﺗﻮﺍﻥ ﭘﻴﺶﺑﻴﻨﻲ ﺧﻄﺮ ﻣﺒﺎﺩﺭﺕ ﺑﻪ ﺧﻮﺩﻛﺸﻲ ﺩﺭ ﺍﻓﺮﺍﺩ ﻣﺒﺘﻼ ﺑﻪ ﺍﻓﺴﺮﺩﮔﻲ‪ ،‬ﺑﻪ‬ ‫ﻋﺪﻩﺍﻱ ﺍﺯ ﻣﺤﻘﻘﻴﻦ ﻣﻌﺘﻘﺪﻧﺪ ﻫﺮﮔﻮﻧﻪ ﺗﻐﻴﻴﺮ ﺩﺭ ﺗﻮﺍﺯﻥ ﻣﺘﺎﺑﻮﻟﻴﺴﻢ ﭼﺮﺑﻲﻫﺎﻯ ﻣﻐﺰ‬
‫ﻣﻨﻈﻮﺭ ﭘﻴﺸﮕﻴﺮﻱ ﺍﺯ ﺍﻗﺪﺍﻡ ﺑﻪ ﺧﻮﺩﻛﺸﻲ ﺩﺭ ﺍﻳﻦ ﺍﻓﺮﺍﺩ ﻋﺪﻩﺍﻱ ﺍﺯ ﻣﺤﻘﻘﻴﻦ ﺑﻪ‬ ‫ﺗﺎﺛﻴﺮﺍﺗﻲ ﺍﺳﺎﺳﻲ ﻭ ﻗﺎﺑﻞ ﺗﻮﺟﻪ ﺑﺮ ﻛﻨﺶﻫﺎ ﻭ ﻓﻌﺎﻟﻴﺖﻫﺎﻱ ﺁﻥ ﺧﻮﺍﻫﺪ ﺩﺍﺷﺖ‬
‫ﻣﻄﺎﻟﻌﻪ ﻭ ﺑﺮﺭﺳﻲ ﺭﺍﺑﻄﻪ ﻣﻴﺎﻥ ﺳﻄﻮﺡ ﻛﻠﺴﺘﺮﻭﻝ ﺧﻮﻥ ﻭ ﺧﻮﺩﻛﺸﻲ ﻭ ﺧﺸﻮﻧﺖ‬ ‫)ﻣﻚ ﻟﻮﻟﻴﻦ ﻭ ﻛﻼﺭﻙ‪ .(1989 ،‬ﻋﻠﻲﺭﻏﻢ ﻭﺍﻗﻌﻴﺖﻫﺎﻯ ﻣﻮﺭﺩ ﺍﺷﺎﺭﻩ‪ ،‬ﺑﻪ ﻧﻈﺮ‬
‫ﺩﺭ ﺍﻓﺮﺍﺩ ﻭ ﻧﻤﻮﻧﻪﻫﺎﻱ ﻣﺨﺘﻠﻒ ﭘﺮﺩﺍﺧﺘﻨﺪ ))ﺁﺗﻤﺎﺳﺎ‪ ،‬ﻛﻮﻟﮕﻮ‪ ،‬ﺗﺰﻛﺎﻥ ﻭ ﻫﻤﻜﺎﺭﺍﻥ‪،‬‬ ‫ﻣﻲﺭﺳﺪ ﻛﻪ ﺩﺭ ﺗﻮﺻﻴﻪﻫﺎ ﻭ ﺗﻼﺵﻫﺎﻯ ﺻﻮﺭﺕ ﮔﺮﻓﺘﻪ ﺑﻪ ﻣﻨﻈﻮﺭ ﻛﺎﻫﺶ ﻭﻗﻮﻉ‬
‫‪2002‬؛ ﮔﻮﻟﻮﻣﺐ‪ ،‬ﺍﺳﺘﺎﺗﻴﻦ ﻭ ﻣﺪﻧﻴﻚ‪2000 ،‬؛ ﻛﺎﭘﻼﻥ‪ ،‬ﻣﻮﻟﺪﻭﻡ‪ ،‬ﻣﺎﻧﻮﻙ ﻭ‬ ‫ﺑﻴﻤﺎﺭﻱﻫﺎﻱ ﻗﻠﺒﻲ‪ -‬ﻋﺮﻭﻗﻲ ﺍﺯ ﻃﺮﻳﻖ ﻛﺎﻫﺶ ﺳﻄﺢ ﭼﺮﺑﻲﻫﺎﻱ ﺭژﻳﻢ ﻏﺬﺍﻳﻲ‪،‬‬
‫ﻫﻤﻜﺎﺭﺍﻥ‪ .(1997 ،‬ﻧﺘﺎﻳﺞ ﺍﻳﻦ ﻣﻄﺎﻟﻌﺎﺕ ﻧﺸﺎﻥ ﻣﻲﺩﺍﺩ ﻛﻪ ﺳﻄﻮﺡ ﻛﻠﺴﺘﺮﻭﻝ‬ ‫ﭼﻪ ﺩﺭ ﻏﺎﻟﺐ ﭘﻴﺸﮕﺮﻱﻫﺎﻱ ﺩﺭﻣﺎﻧﻲ‪ ،‬ﻭ ﭼﻪ ﺩﺭ ﻏﺎﻟﺐ ﺳﻴﺎﺳﺖﮔﺰﺍﺭﻱﻫﺎﻱ‬
‫ﺧﻮﻥ ﺩﺭ ﺑﻴﻤﺎﺭﺍﻥ ﺍﻓﺴﺮﺩﻩﺍﻱ ﻛﻪ ﺗﻤﺎﻳﻞ ﺑﻴﺸﺘﺮﻱ ﺑﻪ ﺧﻮﺩﻛﺸﻲ ﺩﺍﺭﻧﺪ‪ ،‬ﺑﻪ ﻃﻮﺭ‬ ‫ﺟﻤﻌﻴﺘﻲ‪ ،‬ﺗﺎﺛﻴﺮﺍﺕ ﺍﺣﺘﻤﺎﻟﻲ ﭼﻨﻴﻦ ﺗﻐﻴﻴﺮﺍﺗﻲ( ﺩﺭ ﺭژﻳﻢ ﻏﺬﺍﻳﻲ‪ ،‬ﺑﺮ ﺧﻠﻖ ﻭ‬ ‫‪24‬‬
‫ﻣﻌﻨﺎﺩﺍﺭﻱ ﭘﺎﻳﻴﻦ ﻣﻲﺑﺎﺷﺪ‪ .‬ﺩﺭﻫﻤﻴﻦ ﺭﺍﺳﺘﺎ ﺷﻤﺎﺭﻯ ﺍﺯ ﻣﻄﺎﻟﻌﺎﺕ ﺍﻧﺠﺎﻡ ﺷﺪﻩ‬ ‫ﻛﻨﺶﻫﺎﻱ ﺷﻨﺎﺧﺘﻲ ﺍﺯ ﺟﻤﻠﻪ ﺍﻓﺴﺮﺩﮔﻲ ﺗﻮﺟﻪ ﺍﻧﺪﻛﻲ ﺭﺍ ﺑﻪ ﺧﻮﺩ ﺟﻠﺐ ﻧﻤﻮﺩﻩ‬
‫ﺳﻄﻮﺡ ﭘﺎﻳﻴﻦ ﻛﻠﺴﺘﺮﻭﻝ ﺧﻮﻥ‪ ،‬ﺧﺼﻮﺻﺎ ﭘﺎﻳﻴﻦﺗﺮ ‪ 160‬ﻣﻴﻠﻰﮔﺮﻡ ﺩﺭ ﻣﻴﻠﻲﻟﻴﺘﺮ‬ ‫ﺍﺳﺖ‪ .‬ﺩﺭ ﺩﻫﻪ ‪ 80‬ﺑﻪ ﻫﻨﮕﺎﻡ ﺑﺮﺭﺳﻲ ﻧﺘﺎﻳﺞ ﺗﻼﺵﻫﺎ ﻭ ﻣﺪﺍﺧﻼﺕ ﺑﻪ ﻋﻤﻞ‬
‫ﺭﺍ ﺑﺎ ﺍﻓﺰﺍﻳﺶ ﺧﻄﺮ ﻣﺮگ ﺩﺭ ﺍﺛﺮ ﺧﻮﺩﻛﺸﻰ ﻣﺮﺗﺒﻂ ﺩﺍﻧﺴﺘﻪﺍﻧﺪ ))ﺑﻮﺳﺘﻦ‪ ،‬ﺩﻭﺭﺳﻦ‬ ‫ﺁﻣﺪﻩ ﺟﻬﺖ ﻛﻨﺘﺮﻝ ﻭ ﭘﻴﺶﮔﻴﺮﻱ ﺍﺯ ﻧﺎﺭﺍﺣﺘﻲﻫﺎ ﻭ ﺑﻴﻤﺎﺭﻯﻫﺎﻯ ﻗﻠﺒﻲ‪ -‬ﻋﺮﻭﻗﻲ‪،‬‬
‫‪1996‬؛ ﭘﺎﺭﺗﻮﻧﻦ‪ ،‬ﻫﺎﻭﻛﺎ‪ ،‬ﻭﻳﺮﺗﺎﻣﻮ ﻭ ﻫﻤﻜﺎﺭﺍﻥ‪1999 ،‬؛ ﻭ ﺳﺎﺭﺍﺷﻴﭙﻮﻥ‪،‬‬‫ﻭ ﺭﻭﻟﻰ‪1996 ،‬‬ ‫ﺑﻪ ﻭﺍﺳﻄﻪ ﻛﻨﺘﺮﻝ ﺭژﻳﻢ ﻏﺬﺍﻳﻲ ﻳﺎ ﻣﺼﺮﻑ ﺩﺍﺭﻭ‪ ،‬ﻣﺸﺨﺺ ﮔﺮﺩﻳﺪ ﻛﻪ ﺑﺮﻏﻢ‬
‫ﻛﺎﻣﺎﺭﺩﺱ‪ ،‬ﺭﻭﻯ‪ ،‬ﺩﻻﻛﺎﺳﺎ‪ ،‬ﺳﺎﺗﺎ‪ ،‬ﮔﻮﻧﺰﺍﻟﺲ‪ .(2001 ،‬ﻛﻴﻢ ﻭ ﻣﻴﻨﺖ )‪(2004‬‬ ‫ﻣﻮﻓﻘﻴﺖ ﺗﻼﺵﻫﺎﻯ ﺑﻪ ﻋﻤﻞ ﺁﻣﺪﻩ ﺩﺭ ﺭﺍﺑﻄﻪ ﺑﺎ ﻛﺎﻫﺶ ﻣﻴﺰﺍﻥ ﻣﺮگﻫﺎﻱ‬
‫ﻧﻴﺰ ﻃﻲ ﭘﮋﻭﻫﺸﻲ ﻧﺸﺎﻥ ﺩﺍﺩﻧﺪ ﻛﻪ ﺳﻄﻮﺡ ﻛﻠﺴﺘﺮﻭﻝ ﺧﻮﻥ ﺩﺭ ﺑﻴﻦ ﺑﻴﻤﺎﺭﺍﻥ‬ ‫ﻧﺎﺷﻰ ﺍﺯ ﺑﻴﻤﺎﺭﻯﻫﺎﻯ ﻗﻠﺒﻲ‪ -‬ﻋﺮﻭﻗﻲ ﻧﺮﺥ ﻛﻠﻰ ﻣﻴﺰﺍﻥ ﻣﺮگ ﻭ ﻣﻴﺮ ﻧﺸﺎﻥ‬
‫ﺍﻓﺴﺮﺩﻩﺍﻱ ﻛﻪ ﻣﺒﺎﺩﺭﺕ ﺑﻪ ﺧﻮﺩﻛﺸﻰ ﻧﻤﻮﺩﻩ ﺑﻮﺩﻧﺪ ﺑﻪ ﻃﻮﺭ ﻣﻌﻨﺎﺩﺍﺭﻱ ﭘﺎﻳﻴﻦﺗﺮ ﺍﺯ‬ ‫ﺩﻫﻨﺪﻩ ﻛﺎﻫﺶ ﻣﺤﺴﻮﺳﻰ ﻧﺒﻮﺩ‪ .‬ﭼﺎﻟﺶ ﺑﻮﺟﻮﺩ ﺁﻣﺪﻩ ﻣﺤﻘﻘﻴﻦ ﻣﺨﺘﻠﻔﻲ ﺭﺍ ﺑﺮﺁﻥ‬
‫ﮔﺮﻭﻫﻲ ﺑﻮﺩ ﻛﻪ ﺍﻗﺪﺍﻡ ﺑﻪ ﺧﻮﺩﻛﺸﻲ ﻧﻜﺮﺩﻩ ﺑﻮﺩﻧﺪ‪.‬‬ ‫ﺩﺍﺷﺖ ﺗﺎ ﺑﻪ ﺗﺒﻴﻴﻦ ﺷﺮﺍﻳﻂ ﻣﺸﺎﻫﺪﻩ ﺷﺪﻩ ﺑﭙﺮﺩﺍﺯﻧﺪ‪ .‬ﻫﻤﺰﻣﺎﻥ ﺑﺎ ﺍﻳﻦ ﺑﺮﺭﺳﻲﻫﺎ‬
‫ﺍﻟﺒﺘﻪ ﺗﻤﺎﻣﻰ ﻣﻄﺎﻟﻌﺎﺕ ﺍﻧﺠﺎﻡ ﺷﺪﻩ ﻧﺸﺎﻥ ﺩﻫﻨﺪﻩ ﺭﺍﺑﻄﻪ ﻣﻴﺎﻥ ﭼﺮﺑﻲﻫﺎ‬ ‫ﻣﺸﺨﺺ ﮔﺮﺩﻳﺪ ﻛﻪ ﻧﺮﺥ ﻛﺎﻫﺶ ﻣﺮگ ﻭ ﻣﻴﺮ ﺩﺭ ﺭﺍﺑﻄﻪ ﺑﺎ ﺳﻄﻮﺡ ﻛﻠﺴﺘﺮﻭﻝ‬
‫ﻭﻟﻴﭙﻮﭘﺮﻭﺗﺌﻴﻦﻫﺎﻱ ﺧﻮﻥ ﻭ ﻣﻴﺰﺍﻥ ﺧﻄﺮ ﻣﺒﺎﺩﺭﺕ ﺑﻪ ﺧﻮﺩﻛﺸﻲ ﻧﺒﻮﺩﻧﺪ‪ .‬ﺑﻪ ﻃﻮﺭ‬ ‫ﺧﻮﻥ ﻧﻤﺎﻳﻲ‪ U‬ﺷﻜﻞ ﺩﺍﺭﺩ ﺑﻪ ﻃﻮﺭﻱ ﻛﻪ ﺑﺎ ﺍﻓﺰﺍﻳﺶ ﻣﻴﺰﺍﻥ ﻛﻠﺴﺘﺮﻭﻝ ﺧﻮﻥ‬
‫ﻣﺜﺎﻝ ﺁﻟﻤﻴﺪﺍ ﻣﻮﻧﺘﺰ ﻭ ﻫﻤﻜﺎﺭﺍﻧﺶ )ﺁﻟﻤﻴﺪﺍ ﻣﻮﻧﺘﺰ‪ ،‬ﻭﺍﻟﺰﺳﺎﻧﭽﺰ‪ ،‬ﻣﻮﺭﻧﻮﺍﮔﻴﻼﺭ‪،‬‬ ‫ﺍﺯ ﺳﻄﺢ ﻃﺒﻴﻌﻲ ﻣﻴﺰﺍﻥ ﻣﺮگ ﻭ ﻣﻴﺮ ﻗﻠﺒﻲ‪ -‬ﻋﺮﻭﻗﻲ ﺍﻓﺰﺍﻳﺶ ﻳﺎﻓﺘﻪ ﺩﺭ ﺣﺎﻟﻴﻜﻪ‬
‫ﭼﺎﻭﺯﺑﻠﺪﺭ‪ ،‬ﮔﺎﺭﺳﻴﺎ ﻣﺎﺭﻳﻦ‪ ،‬ﻫﻴﻨﺰ ﻣﺎﺭﺗﻴﻦ‪ (2000 ،‬ﻃﻲ ﻣﻄﺎﻟﻌﻪﺍﻯ ﻧﺸﺎﻥ‬ ‫ﻫﻤﺰﻣﺎﻥ ﺑﺎ ﻛﺎﻫﺶ ﻣﻴﺰﺍﻥ ﻛﻠﺴﺘﺮﻭﻝ ﺍﺯ ﺳﻄﺢ ﻃﺒﻴﻌﻲ‪ ،‬ﻣﻴﺰﺍﻥ ﻣﺮگﻫﺎﻱ ﻏﻴﺮ‬
‫ﺩﺍﺩﻧﺪ ﻛﻪ ﺗﻔﺎﻭﺕ ﻣﻌﻨﺎﺩﺍﺭﻯ ﺑﻴﻦ ﻧﻴﻤﺮﺥ ﭼﺮﺑﻰ ﺧﻮﻥ ﺑﻴﻤﺎﺭﺍﻧﻰ ﻛﻪ ﺍﻗﺪﺍﻡ ﺑﻪ‬ ‫‪3‬‬
‫ﻗﻠﺒﻲ‪ -‬ﻋﺮﻭﻗﻰ‪ 2‬ﻭ ﻧﺎ ﻣﺮﺗﺒﻂ ﺑﺎ ﺑﻴﻤﺎﺭﻱﻫﺎ ﻳﺎ ﺍﺻﻄﻼﺣ ًﺎ ﻣﺮگ ﻭ ﻣﻴﺮ ﺗﺼﺎﺩﻓﻰ‬
‫ﺧﻮﺩﻛﺸﻰ ﻛﺮﺩﻩ ﺑﻮﺩﻧﺪ ﻭ ﺑﻴﻤﺎﺭﺍﻧﻰ ﻛﻪ ﻣﺒﺎﺩﺭﺕ ﺑﻪ ﺧﻮﺩﻛﺸﻰ ﻧﻨﻤﻮﺩﻩ ﺑﻮﺩﻧﺪ‪،‬‬ ‫ﺍﻓﺰﺍﻳﺶ ﻣﻲﻳﺎﻓﺖ‪ .‬ﻣﺸﺎﻫﺪﻩ ﺗﻜﺮﺍﺭ ﻧﺘﺎﻳﺞ ﻓﻮﻕ ﺩﺭ ﻣﻄﺎﻟﻌﺎﺕ ﻣﺨﺘﻠﻒ ﮔﻤﺎﻥ‬
‫ﻭﺟﻮﺩ ﻧﺪﺍﺷﺖ‪.‬‬ ‫ﺍﺣﺘﻤﺎﻟﻲ ﺑﻮﺩﻥ ﻧﺘﺎﻳﺞ ﺑﺪﺳﺖ ﺁﻣﺪﻩ ﺭﺍ ﻣﻨﺘﻔﻲ ﻧﻤﻮﺩﻩ ﻭ ﻣﻮﺟﺐ ﺗﺪﻭﻳﻦ ﻭ ﺍﺟﺮﺍﻱ‬
‫ﺩﺭ ﺍﺩﺍﻣﻪ ﻋﺪﻩﺍﻱ ﺍﺯ ﻣﺤﻘﻘﻴﻦ ﺑﻪ ﺑﺮﺭﺳﻲ ﺭﺍﺑﻄﻪ ﻣﻴﺎﻥ ﺳﻄﻮﺡ ﭼﺮﺑﻲﻫﺎﻱ‬ ‫ﺗﺤﻘﻴﻘﺎﺕ ﻣﺨﺘﻠﻒ ﺟﻬﺖ ﺑﺮﺭﺳﻰ ﺭﺍﺑﻄﻪ ﺍﺣﺘﻤﺎﻟﻰ ﻣﻴﺎﻥ ﺳﻄﻮﺡ ﻛﻠﺴﺘﺮﻭﻝ ﺧﻮﻥ‬
‫ﺧﻮﻥ ﺑﺎ ﺧﻠﻖ ﻭ ﺍﻓﺴﺮﺩﮔﻲ ﭘﺮﺩﺍﺧﺘﻨﺪ ﻭ ﻧﺸﺎﻥ ﺩﺍﺩﻧﺪ ﻛﻪ ﺑﻴﻦ ﺳﻄﻮﺡ ﭘﺎﻳﻴﻦ‬ ‫ﻭ ﻣﺮگﻫﺎﻱ ﺗﺼﺎﺩﻓﻲ ﻳﺎ ﻏﻴﺮﻣﺮﺗﺒﻂ ﺑﺎ ﺑﻴﻤﺎﺭﻱﻫﺎ ﮔﺮﺩﻳﺪ‪ .‬ﺍﻳﻦ ﻣﻄﺎﻟﻌﺎﺕ ﺩﺭ ﺍﺑﺘﺪﺍ‬
‫ﻛﻠﺴﺘﺮﻭﻝ ﺧﻮﻥ ﻭ ﺍﻓﺴﺮﺩﮔﻰ ﺍﺳﺎﺳﻰ ﻫﻤﺒﺴﺘﮕﻰ ﻭﺟﻮﺩ ﺩﺍﺭﺩ‪) .‬ﺍﺳﺘﻴﮕﻤﻦ‪،‬‬ ‫ﺑﺮ ﻣﻴﺰﺍﻥ ﻣﺮگ ﻭ ﻣﻴﺮ ﺩﺭ ﮔﺮﻭﻩﻫﺎﻱ ﻛﺎﻫﺶ ﻭ ﻛﻨﺘﺮﻝ ﭼﺮﺑﻲ ﺧﻮﻥ ﻣﺘﻤﺮﻛﺰ‬
‫ﻫﻮﺯ‪ ،‬ﺑﺎﻙ‪ ،‬ﻭﺍﻧﺪﺭﺩﺯ ﻭ ﮔﺮﻭﺑﻰ‪2000،‬؛ ﺍﻭﻟﻮﺳﻰ ﻭ ﻓﻴﺪﻭ‪1996،‬؛ ﺗﺮﺍﻭ‪ ،‬ﺍﻳﻮﺍﺗﺎ‪،‬‬ ‫ﺑﻮﺩﻧﺪ‪ .‬ﺑﻪ ﻃﻮﺭﻳﻜﻪ ﻣﻄﺎﻟﻌﺎﺕ ﺟﻤﻌﻴﺖ ﺷﻨﺎﺧﺘﻲ ﻣﺨﺘﻠﻒ ﺑﻪ ﺭﺍﺑﻄﻪ ﻣﻌﻜﻮﺱ‬
‫ﻛﺎﻧﺎﺯﺍﻭﺍ‪ ،‬ﺗﺎﻛﺎﻧﻮ‪ ،‬ﺗﺎﻛﺎﻫﺎﺷﻰ‪ ،‬ﻫﺎﻳﺎﺷﻰ ﻭ ﺳﻮﮔﺎﻭﺍﺭﺍ‪2000 ،‬؛ ﺭﺍﺏ‪ -‬ﺟﺎﺑﻠﻮﻧﺴﻜﺎ‬ ‫ﻣﻴﺎﻥ ﺳﻄﻮﺡ ﻛﻠﺴﺘﺮﻭﻝ ﺧﻮﻥ ﻭ ﻣﺮگﻫﺎﻱ ﻏﻴﺮﻗﻠﺒﻰ‪-‬ﻋﺮﻭﻗﻰ ﺧﺼﻮﺻﺎ ﻣﺮگ‬

‫‪1- cardiovascular‬‬ ‫‪3 -non illness related‬‬

‫‪2- non cardiovascular‬‬ ‫‪4- cholesterol lowering Therapy‬‬
 ‫ﻃﺒﺎﻃﺒﺎﺋﻲ ﻭ ﻫﻤﻜﺎﺭﺍﻥ‬
‫ﻣﻴﻠﺖ‪ ،‬ﮔﺎﺭﺗﺴﺎﻳﺪ‪ ،‬ﺍﻟﺴﺘﻦ ﻭ ﮔﻮ‪1975 ،‬؛ ﮔﻠﻮﻙ‪ ،‬ﺗﺎﻳﮕﺮ‪ ،‬ﻛﻮﻧﻜﻞ‪ ،‬ﺗﺮﻳﺴﻰ‪،‬‬
‫ﺍﺳﭙﻴﺮﺯ‪ ،‬ﺍﺳﺘﺮﻳﭽﺮ ﻭ ﺍﻳﻠﻴﻨﮓ‪ .(1993 ،‬ﻣﻄﺎﺑﻖ ﮔﺰﺍﺭﺵﻫﺎﻯ ﺗﺤﻘﻴﻘﺎﺗﻰ ﺍﻳﻦ‬
‫ﺩﺳﺘﻪ ﺍﺯ ﻣﺤﻘﻘﻴﻦ‪ ،‬ﻫﻨﮕﺎﻣﻲ ﻛﻪ ﺳﻄﺢ ﺗﺮﻱﮔﻠﻴﺴﻴﺮﻳﺪ ﺧﻮﻥ ﺍﻓﺮﺍﺩ ﻣﺒﺘﻼ ﺑﻪ‬
‫ﻫﻴﭙﺮﺗﺮﻱﮔﻠﻴﺴﻴﺮﻳﺪﻣﻴﺎﻱ ﻓﺎﻣﻴﻠﻲ ﺑﻪ ﺣﺪ ﻃﺒﻴﻌﻲ ﺑﺎﺯﮔﺮﺩﺍﻧﺪﻩ ﻣﻲﺷﺪ‪ ،‬ﻫﻤﺰﻣﺎﻥ‬
‫ﺑﻬﺒﻮﺩﻱ ﻣﻌﻨﺎﺩﺍﺭﻱ ﺩﺭ ﻧﺸﺎﻧﻪﻫﺎﻱ ﺍﻓﺴﺮﺩﮔﻲ ﺍﻳﻦ ﺍﻓﺮﺍﺩ ﺭﺥ ﻣﻲﺩﺍﺩ )ﮔﻠﻮﻙ‪،‬‬
‫ﺗﺎﻳﮕﺮ‪ ،‬ﻛﻮﻧﻜﻞ ﻭ ﻫﻤﻜﺎﺭﺍﻥ‪ .(1993 ،‬ﺑﺮﻣﺒﻨﺎﻱ ﻳﺎﻓﺘﻪﻫﺎﻱ ﺑﺪﺳﺖ ﺁﻣﺪﻩ‪،‬‬
‫ﺧﻮﻥ ﺩﺭ ﺍﻧﻮﺍﻉ ﺑﻴﻤﺎﺭﻯﻫﺎﻯ ﺧﻠﻘﻰ ﻧﻈﻴﺮ ﺍﺧﺘﻼﻝ ﺩﻭ ﻗﻄﺒﻰ‪ ،1‬ﺳﺎﻳﻜﻮﺍﻓﻜﺘﻴﻮ‬
‫ﻋﺪﻩﺍﻱ ﺍﺯ ﻣﺤﻘﻘﻴﻦ ﺍﻳﻦ ﻓﺮﺽ ﺭﺍ ﻣﻄﺮﺡ ﻧﻤﻮﺩﻧﺪ ﻛﻪ ﻧﺸﺎﻧﻪﻫﺎﻱ ﺍﻓﺴﺮﺩﮔﻲ‬
‫ﺩﺭ ﺑﻴﻤﺎﺭﺍﻥ ﻣﺒﺘﻼ ﺑﻪ ﻫﻴﭙﺮﺗﺮﻱﮔﻠﻴﺴﻴﺮﻳﺪﻣﻴﺎﻱ ﻓﺎﻣﻴﻠﻲ‪ ،‬ﺣﺎﺻﻞ ﭼﺴﺒﻨﺪﮔﻲ‬
‫ﺧﻮﻥ ﻭ ﺑﻪ ﺗﺒﻊ ﺁﻥ ﻛﺎﻫﺶ ﺟﺮﻳﺎﻥ ﻭ ﺍﻧﺘﺸﺎﺭ ﺧﻮﻥ ﺩﺭ ﻧﻮﺍﺣﻲ ﻣﻐﺰﻱ ﻣﻲﺑﺎﺷﺪ‬
‫)ﻓﻼﺕ ﻭ ﮔﻠﻮﻙ‪1976،‬؛ ﮔﻠﻮﻙ‪ ،‬ﻛﻮﻧﻜﻞ‪ ،‬ﺗﺮﻳﺴﻰ ﻭ ﻫﻤﻜﺎﺭﺍﻥ‪ .(1995 ،‬ﺩﺭ‬
‫ﻫﻤﻴﻦ ﺭﺍﺳﺘﺎ ﻣﻄﺎﻟﻌﺎﺕ ﻣﺨﺘﻠﻒ ﻧﺸﺎﻥ ﺩﺍﺩﻩﺍﻧﺪ ﻛﻪ ﺳﻄﺢ ﺗﺮﻱﮔﻠﻴﺴﻴﺮﻳﺪ ﺧﻮﻥ‬
‫ﺍﻓﺮﺍﺩ ﺑﺰﺭﮔﺴﺎﻝ ﻭ ﻛﻮﺩﻛﺎﻥ ﻣﺒﺘﻼ ﺑﻪ ﺍﺧﺘﻼﻻﺕ ﻋﺎﻃﻔﻰ‪ 8‬ﻛﻪ ﺩﺍﺭﺍﻱ ﺳﺎﺑﻘﻪ‬
‫ﺑﺴﺘﺮﻱ ﺷﺪﻥ ﺑﻪ ﺳﺒﺐ ﺑﻴﻤﺎﺭﻱﻫﺎﻱ ﺭﻭﺍﻥﺷﻨﺎﺧﺘﻲ ﻣﻲﺑﺎﺷﻨﺪ‪ ،‬ﺑﺎﻻﺗﺮ ﺍﺯ ﺣﺪ‬
‫ﻃﺒﻴﻌﻲ ﺍﺳﺖ )ﮔﻠﻮﻙ‪ ،‬ﺗﺎﻳﮕﺮ‪ ،‬ﻛﻮﻧﻜﻞ ﻭ ﻫﻤﭙﺮ‪.(1994،‬‬
‫ﻧﻈﺮ ﺑﻪ ﺍﻓﺰﺍﻳﺶ ﺭﻭﺯ ﺍﻓﺰﻭﻥ ﻧﺮﺥ ﺑﻴﻤﺎﺭﻱﻫﺎﻱ ﻗﻠﺒﻲ ﻋﺮﻭﻗﻲ ﻭ ﻣﺘﺪﺍﻭﻝ‬
‫ﺷﺪﻥ ﺷﻴﻮﻩﻫﺎﻱ ﻣﺨﺘﻠﻒ ﻛﻨﺘﺮﻝ ﺳﻄﻮﺡ ﻛﻠﺴﺘﺮﻭﻝ ﺧﻮﻥ ﺩﺭ ﺍﻳﺮﺍﻥ ﺍﺯ ﻳﻚ‬
‫ﺳﻮ‪ ،‬ﻭ ﺟﺪﻱ ﺑﻮﺩﻥ ﺗﻬﺪﻳﺪﺍﺕ ﻣﺮﺗﺒﻂ ﺑﺎ ﭘﻴﺎﻣﺪﻫﺎﻱ ﻧﺎﺧﻮﺍﺳﺘﻪ ﭘﺎﻳﻴﻦ ﺑﻮﺩﻥ‬
‫ﺳﻄﻮﺡ ﭼﺮﺑﻲﻫﺎﻱ ﺧﻮﻥ ﺍﺯ ﺳﻮﺋﻰ ﺩﻳﮕﺮ‪ ،‬ﺿﺮﻭﺭﺕ ﺁﮔﺎﻫﻲ ﺍﺯ ﻋﻮﺍﺭﺽ‬
‫ﺍﺣﺘﻤﺎﻟﻲ ﻭ ﻧﺎﺧﻮﺍﺳﺘﻪ ﻣﺮﺗﺒﻂ ﺑﺎ ﺳﻄﻮﺡ ﭼﺮﺑﻲﻫﺎﻯ ﺧﻮﻥ ﺑﻴﺶ ﺍﺯ ﭘﻴﺶ‬
‫ﻧﻤﺎﻳﺎﻥ ﻣﻰﮔﺮﺩﺩ‪ .‬ﻫﻤﺎﻥ ﻃﻮﺭ ﻛﻪ ﻣﺸﺎﻫﺪﻩ ﮔﺮﺩﻳﺪ ﺗﺤﻘﻴﻘﺎﺕ ﺻﻮﺭﺕ ﮔﺮﻓﺘﻪ‬
‫ﺩﺭ ﺍﻳﻦ ﺣﻮﺯﻩ ﻋﻤﺪﺗ ًﺎ ﺑﻪ ﻧﺘﺎﻳﺞ ﺿﺪ ﻭ ﻧﻘﻴﻀﻰ ﺩﺳﺖ ﻳﺎﻓﺘﻪﺍﻧﺪ‪ .‬ﺍﻳﻦ ﺩﺭﺣﺎﻟﻴﺴﺖ‬
‫ﻭﻳﻨﮕﺮﻫﻮﺗﺰ ﻭ ﻫﻤﻜﺎﺭﺍﻧﺶ )‪ (1997‬ﺩﺭ ﺭﺍﺑﻄﻪ ﺑﺎ ﺯﻧﺎﻥ ﻣﻴﺎﻧﺴﺎﻝ ﻣﺸﺎﻫﺪﻩ ﮔﺮﺩﻳﺪ‬
‫ﻛﻪ ﻣﺮﻭﺭ ﺍﺩﺑﻴﺎﺕ ﭘﮋﻭﻫﺸﻰ ﻧﺸﺎﻥ ﻣﻰﺩﻫﺪ‪ ،‬ﺩﺭ ﺗﺤﻘﻴﻘﺎﺕ ﺍﻧﺠﺎﻡ ﺷﺪﻩ ﺗﺎﺛﻴﺮ‬
‫ﻣﺘﻘﺎﺑﻞ ﻣﺘﻐﻴﻴﺮﻫﺎﻯ ﻣﺨﺘﻠﻒ ﻧﻈﻴﺮ ﺳﻄﺢ ﺗﺮﻯﮔﻠﻴﺴﻴﺮﻳﺪ ﻭ ﻟﻴﭙﻮﭘﺮﻭﺗﺌﻴﻦﻫﺎﻯ‬
‫‪25‬‬ ‫ﺧﻮﻥ ﺩﺭ ﻛﻨﺎﺭ ﻛﻠﺴﺘﺮﻭﻝ ﺑﺮﺍﻓﺴﺮﺩﮔﻰ ﻣﻮﺭﺩ ﺑﺮﺭﺳﻲ ﻗﺮﺍﺭ ﻧﮕﺮﻓﺘﻪ ﺍﺳﺖ‪ .‬ﺩﺭ‬
‫ﻭﺍﻗﻊ ﻫﻤﺎﻥ ﻃﻮﺭ ﻛﻪ ﺍﺷﺎﺭﻩ ﮔﺮﺩﻳﺪ ﺷﻤﺎﺭﻱ ﺍﺯ ﺗﺤﻘﻴﻘﺎﺕ ﻫﻤﺒﺴﺘﮕﻲ ﻣﺴﺘﻘﻴﻢ‬
‫ﺑﻴﻦ ﺳﻄﺢ ﺗﺮﻱﮔﻠﻴﺴﻴﺮﻳﺪ ﺧﻮﻥ ﻭ ﺍﻓﺴﺮﺩﮔﻲ ﺭﺍ ﮔﺰﺍﺭﺵ ﻧﻤﻮﺩﻩﺍﻧﺪ )ﮔﻠﻮﻙ‪،‬‬
‫ﻓﻼﺕ‪ ،‬ﻣﻴﻠﺖ ﻭ ﻫﻤﻜﺎﺭﺍﻥ ‪1975،‬؛ ﮔﻠﻮﻙ‪ ،‬ﺗﺎﻳﮕﺮ‪ ،‬ﻛﻮﻧﻜﻞ ﻭ ﻫﻤﻜﺎﺭﺍﻥ‬
‫‪ (1993‬ﻛﻪ ﻋﻤﺪﺗﺎ ﺩﺭ ﺗﺤﻘﻴﻘﺎﺕ ﻣﺮﺑﻮﻁ ﺑﻪ ﺑﺮﺭﺳﻲ ﺭﺍﺑﻄﻪ ﻣﻴﺎﻥ ﻏﻠﻈﺖﻫﺎﻱ‬
‫ﻛﻠﺴﺘﺮﻭﻝ ﺧﻮﻥ ﻭ ﺍﻓﺴﺮﺩﮔﻲ ﺩﺭ ﻛﻨﺎﺭ ﻛﻠﺴﺘﺮﻭﻝ ﻣﻮﺭﺩ ﻣﻄﺎﻟﻌﻪ ﻗﺮﺍﺭ ﻧﮕﺮﻓﺘﻪ‬
‫ﺍﺳﺖ‪ .‬ﻋﻼﻭﻩ ﺑﺮ ﺗﺮﻱﮔﻠﻴﺴﻴﺮﻳﺪ ﺩﺭ ﻧﻈﺮ ﮔﺮﻓﺘﻦ ﻟﻴﭙﻮﭘﺮﻭﺗﺌﻴﻦﻫﺎﻱ ﺧﻮﻥ‬
‫ﺑﻪ ﻋﻨﻮﺍﻥ ﺑﺨﺸﻲ ﺍﺯ ﻣﺸﺘﻘﺎﺕ ﺧﻮﻧﻲ ﻣﺮﺗﺒﻂ ﺑﺎ ﭼﺮﺑﻲﻫﺎﻱ ﺧﻮﻥ ﻛﻪ ﺑﻪ‬
‫ﺗﺎﺯﮔﻰ ﺩﺭ ﺭﺍﺑﻄﻪ ﺑﺎ ﺍﻓﺴﺮﺩﮔﻰ ﻣﻮﺭﺩ ﻣﻄﺎﻟﻌﻪ ﻗﺮﺍﺭ ﮔﺮﻓﺘﻪﺍﻧﺪ‪ ،‬ﻧﻴﺰ ﺣﺎﺋﺰ ﺍﻫﻤﻴﺖ‬
‫ﻣﻲﺑﺎﺷﺪ‪ ،‬ﻛﻪ ﺗﺎﻛﻨﻮﻥ ﺩﺭ ﺍﻳﻦ ﺭﺍﺑﻄﻪ ﻧﻴﺰ ﭘﮋﻭﻫﺶ ﺛﺒﺖ ﺷﺪﻩﺍﻱ ﺩﺭ ﺍﻳﺮﺍﻥ‬
‫ﺍﻧﺠﺎﻡ ﻧﮕﺮﻓﺘﻪ ﺍﺳﺖ‪ .‬ﺑﻪ ﻧﻈﺮ ﻣﻲﺭﺳﺪ ﺩﺭ ﻧﻈﺮ ﮔﺮﻓﺘﻦ ﺳﺎﻳﺮ ﻣﺘﻐﻴﻴﺮﻫﺎﻱ‬
‫ﻣﺮﺗﺒﻂ ﺑﺎ ﭼﺮﺑﻲﻫﺎﻱ ﺧﻮﻥ ﺩﺭ ﻛﻨﺎﺭ ﻛﻠﺴﺘﺮﻭﻝ‪ ،‬ﻧﻈﻴﺮ ﺳﻄﻮﺡ ﺗﺮﻱﮔﻠﻴﺴﻴﺮﻳﺪ‬
‫ﻭ ﻟﻴﭙﻮﭘﺮﻭﺗﺌﻴﻦﻫﺎﻯ ﺧﻮﻥ ﺑﺘﻮﺍﻧﺪ ﺗﺎ ﺍﻧﺪﺍﺯﻩﺍﻱ ﺭﺍﺑﻄﻪ ﺍﺣﺘﻤﺎﻟﻰ ﻣﻴﺎﻥ ﭼﺮﺑﻰﻫﺎ‬
‫ﻭ ﻟﻴﭙﻮﭘﺮﻭﺗﺌﻴﻦﻫﺎﻯ ﺧﻮﻥ ﻭ ﻣﻴﺰﺍﻥ ﺍﻓﺴﺮﺩﮔﻰ ﺭﺍ ﺭﻭﺷﻦ ﻧﻤﺎﻳﺪ ﺩﺭ ﭘﮋﻭﻫﺶ‬
‫ﺣﺎﺿﺮ ﻧﻴﺰ ﺗﻼﺵ ﮔﺮﺩﻳﺪﻩ ﺍﺳﺖ ﺗﺎ ﺑﺎ ﻫﺪﻑ ﺑﺮﺭﺳﻰ ﺍﻭﻟﻴﻪ ﻭ ﺗﻌﻴﻴﻦ ﺭﺍﺑﻄﻪ‬
‫ﺍﺣﺘﻤﺎﻟﻰ ﺑﻴﻦ ﺳﻄﻮﺡ ﻛﻠﺴﺘﺮﻭﻝ‪ ،‬ﺗﺮﻱﮔﻠﻴﺴﻴﺮﻳﺪ ﻭ ﻟﻴﭙﻮﭘﺮﻭﺗﺌﻴﻦﻫﺎﻱ ﺧﻮﻥ ﺑﺎ‬
‫ﻳﻜﻲ ﺍﺯ ﭘﺮ ﻫﺰﻳﻨﻪﺗﺮﻳﻦ ﺍﺧﺘﻼﻻﺕ ﺭﻭﺍﻥﺷﻨﺎﺧﺘﻰ‪ ،‬ﻳﻌﻨﻰ ﺍﻓﺴﺮﺩﮔﻰ‪ ،‬ﻣﺸﺨﺺ‬
‫ﮔﺮﺩﺩ ﻛﻪ ﺁﻳﺎ ﺑﻴﻦ ﺳﻄﻮﺡ ﻛﻠﺴﺘﺮﻭﻝ‪ ،‬ﺗﺮﻱﮔﻠﻴﺴﻴﺮﻳﺪ‪ ،‬ﻟﻴﭙﻮﭘﺮﻭﺗﺌﻴﻦﻫﺎ ﺑﺎ‬
‫ﭼﮕﺎﻟﻲ ﻛﻢ‪ ( LDL)9‬ﻭﻟﻴﭙﻮﭘﺮﻭﺗﺌﻴﻦ ﻫﺎ ﺑﺎ ﭼﮕﺎﻟﻲ ﺯﻳﺎﺩ‪ (HDL) 10‬ﺧﻮﻥ ﺩﺭ‬
‫‪1- bipolar disorder‬‬
‫‪2- psychoaffective‬‬
‫‪3- manic disorder‬‬
‫‪4- Major Depressive Disorder‬‬
‫‪5- Neo Personality Inventory‬‬
‫ﻭﭘﻮﭘﺮﺍﺳﻜﺎ‪2000،‬؛ ﺭﺍﻓﺘﺮ‪2001 ،‬؛ ﺳﻮﺭﺯ‪1999،‬؛ ﻛﺎﺩﻭ‪ ،‬ﻓﻴﺮﺍﻭﺍﻧﺘﻰ‪ ،‬ﻭ ﺁﻧﺘﻮﻧﻴﺴﻠﻰ‪،‬‬
‫ﮔﺎﺳﭙﺎﺭﻳﻨﻰ ﻭ ﮔﺎﺋﺘﻰ‪1995،‬؛ ﻟﻴﻨﺪﻧﺒﺮگ‪ ،‬ﻻﺭﺳﻦ‪ ،‬ﺳﺘﺮﻟﻴﻨﺪ ﻭ ﺭﺍﺳﺘﺎﻡ‪1994،‬؛‬
‫ﻣﺎﺯ‪ ،‬ﺩﻻﻧﮕﻪ‪ ،‬ﻣﻠﺘﺰﺭ‪ ،‬ﺍﺳﭽﺎﺭﭘﻪ‪ ،‬ﺩﻫﻨﺖ ﻭ ﻛﺴﻴﻦ‪1994،‬؛ ﻣﻮﺭﮔﺎﻥ‪ ،‬ﭘﺎﻟﻴﻨﻜﺎﺱ‪،‬‬
‫‪1993‬؛ ﻭ ﻫﻮﺭﺳﺘﻮﻥ‪ ،‬ﻭﺍﻣﺎﻻ‪ ،‬ﻭﻳﻨﮕﺮﻫﻮﺗﺰ ﻭ ﺍﻭﺭﺗﺎ ﮔﻮﻣﺮ‪،‬‬
‫ﺑﺎﺭﺕ ﻛﺮﻧﺮ ﻭ ﻭﻳﻨﮕﺎﺭﺩ‪1993 ،‬‬
‫‪ .(1997‬ﻗﺎﺋﻤﻰ ﻭ ﻫﻤﻜﺎﺭﺍﻧﺶ ﺩﺭ ﻣﻄﺎﻟﻌﻪﺍﻯ ﺑﻪ ﺑﺮﺭﺭﺳﻰ ﻣﻴﺰﺍﻥ ﻛﻠﺴﺘﺮﻭﻝ‬
‫‪2‬‬
‫ﻭ ﺍﻓﺴﺮﺩﮔﻰ ﺍﺳﺎﺳﻰ ﭘﺮﺩﺍﺧﺘﻨﺪ ﻭ ﻧﺸﺎﻥ ﺩﺍﺩﻧﺪ ﻛﻪ ﺳﻄﻮﺡ ﻛﻠﺴﺘﺮﻭﻝ ﺧﻮﻥ ﺩﺭ‬
‫ﺑﻴﻤﺎﺭﺍﻥ ﻣﺒﺘﻼ ﺑﻪ ﺍﺧﺘﻼﻝ ﻣﺎﻧﻴﻚ‪ 3‬ﻳﺎ ﺍﻓﺴﺮﺩﮔﻰ‪ ،‬ﺩﺭ ﻣﻘﺎﻳﺴﻪ ﺑﺎ ﺑﻴﻤﺎﺭﺍﻧﻰ ﻛﻪ ﺍﺯ‬
‫ﺗﺮﻛﻴﺒﻰ ﺍﺯ ﺍﻳﻦ ﺩﻭ ﺣﺎﻟﺖ ﺭﻧﺞ ﻣﻰﺑﺮﻧﺪ‪ ،‬ﭘﺎﻳﻴﻦﺗﺮ ﺑﻮﺩ ) ﻗﺎﺋﻤﻰ‪ ،‬ﺷﻴﻠﺪ‪ ،‬ﻫﮕﺎﺭﺗﻰ ﻭ‬
‫ﮔﻮﺩﻭﻳﻦ‪ .(2000،‬ﺍﻭﻟﻮﺳﻰ ﻭ ﻓﻴﺪﻭ )‪ (1996‬ﻏﻠﻈﺖ ﻛﻠﺴﺘﺮﻭﻝ ﺧﻮﻥ ‪ 100‬ﺑﻴﻤﺎﺭ‬
‫ﻣﺒﺘﻼ ﺑﻪ ﺍﻓﺴﺮﺩﮔﻰ ﺍﺳﺎﺳﻰ ﺭﺍ ﺑﺎ ﻏﻠﻈﺖ ﻛﻠﺴﺘﺮﻭﻝ ﺧﻮﻥ ‪ 100‬ﻧﻔﺮ ﻫﻤﺘﺎﻯ ﮔﺮﻭﻩ‬
‫ﻛﻨﺘﺮﻝ ﻣﻘﺎﻳﺴﻪ ﻧﻤﻮﺩﻧﺪ‪ .‬ﻧﺘﺎﻳﺞ ﺑﺪﺳﺖ ﺁﻣﺪﻩ ﻧﺸﺎﻥ ﺩﺍﺩ ﻛﻪ ﺳﻄﺢ ﻛﻠﺴﺘﺮﻭﻝ ﺧﻮﻥ‬
‫ﺑﻴﻤﺎﺭﺍﻥ ﻣﺒﺘﻼ ﺑﻪ ﺍﻓﺴﺮﺩﮔﻰ ﺍﺳﺎﺳﻰ ‪ (MDD)4‬ﺩﺭ ﻫﺮ ﺩﻭ ﺟﻨﺲ ﻭ ﺗﻤﺎﻣﻰ‬
‫ﮔﺮﻭﻩﻫﺎﻯ ﺳﻨﻰ ﺑﻪ ﻃﻮﺭ ﻣﻌﻨﺎﺩﺍﺭﻯ ﭘﺎﻳﻴﻦﺗﺮ ﺍﺯ ﺳﻄﺢ ﺁﻥ ﺩﺭ ﮔﺮﻭﻩ ﻛﻨﺘﺮﻝ ﻫﻤﺘﺎ‬
‫ﺑﻪ ﻟﺤﺎﻅ ﺳﻦ‪ ،‬ﺟﻨﺲ‪ ،‬ﻭ ﻭﺯﻥ ﺑﻮﺩ‪ .‬ﻣﻄﺎﻟﻌﺎﺕ ﮔﺮﻭﻫﻲ ﺍﺯﻣﺤﻘﻘﻴﻦ ﻧﻴﺰ ﻧﺸﺎﻥ ﺩﺍﺩﻩ‬
‫ﺍﺳﺖ ﻛﻪ ﺳﻄﻮﺡ ﭘﺎﻳﻴﻦ ﻛﻠﺴﺘﺮﻭﻝ ﺧﻮﻥ ﺧﻄﺮﺍﺑﺘﻼء ﺑﻪ ﺍﻓﺴﺮﺩﮔﻲ ﺍﺳﺎﺳﻰ ﺭﺍ‬
‫ﺍﻓﺰﺍﻳﺶ ﻣﻲﺩﻫﺪ ))ﭘﺎﺭﺗﻮﻧﻦ‪ ،‬ﻫﺎﻭﻛﺎ‪ ،‬ﻭﻳﺮﺗﺎﻣﻮ ﻭﻫﻤﻜﺎﺭﺍﻥ‪ .(1999 ،‬ﮔﺮﻭﻩ ﺩﻳﮕﺮﻱ‬
‫ﺍﺯ ﻣﺤﻘﻘﻴﻦ )ﻣﻮﺭﮔﺎﻥ‪ ،‬ﭘﺎﻟﻴﻨﻜﺎﺱ‪ ،‬ﺑﺎﺭﺕ ﻛﺮﻧﺮ ﻭ ﻭﻳﻨﮕﺎﺭﺩ‪ (1993 ،‬ﻧﻴﺰ ﺭﺍﺑﻄﻪ‬
‫ﺳﻄﻮﺡ ﭘﺎﻳﻴﻦ ﻛﻠﺴﺘﺮﻭﻝ ﺧﻮﻥ ﺑﺎ ﺷﺪﺕ ﻧﺸﺎﻧﻪﻫﺎﻯ ﺍﻓﺴﺮﺩﮔﻰ ﺭﺍ ﺩﺭ ﮔﺮﻭﻫﻲ ﺍﺯ‬
‫ﻣﺮﺩﺍﻥ ﺳﺎﻟﺨﻮﺭﺩﻩ ﮔﺰﺍﺭﺵ ﻧﻤﻮﺩﻧﺪ‪ .‬ﻧﻈﻴﺮ ﺍﻳﻦ ﺭﺍﺑﻄﻪ ﺗﻮﺳﻂ ﻫﻮﺭﺳﺘﻮﻥ‪ ،‬ﻭﺍﻣﺎﻻ‪،‬‬
‫ﮔﺮﺩﻳﺪ‪.‬‬
‫ﺳﻮﺍﺭﺯ )‪ (1999‬ﻃﻲ ﭘﮋﻭﻫﺸﻲ ﺭﺍﺑﻄﻪ ﻣﻴﺎﻥ ﭘﺎﻳﻴﻦ ﺑﻮﺩﻥ ﺑﺪﻭﻥ ﻣﺪﺍﺧﻠﻪ ﻏﻠﻈﺖ‬
‫ﭼﺮﺑﻰ ﻭ ﻟﻴﭙﻮﭘﺮﻭﺗﺌﻴﻦﻫﺎﻯ ﺧﻮﻥ ﺑﺎ ﺭﮔﻪﻫﺎﻯ ﺍﺿﻄﺮﺍﺏ ﻭ ﺍﻓﺴﺮﺩﮔﻰ ﺭﺍ ﻣﻮﺭﺩ‬
‫ﺑﺮﺭﺳﻰ ﻭ ﭘﮋﻭﻫﺶ ﻗﺮﺍﺭ ﺩﺍﺩ‪ .‬ﻧﺘﺎﻳﺞ ﺑﺪﺳﺖ ﺁﻣﺪﻩ ﻧﺸﺎﻥ ﺩﺍﺩ ﻛﻪ ﻧﻤﺮﺍﺕ ﺯﻳﺮ ﻋﺎﻣﻞ‬
‫ﺍﻓﺴﺮﺩﮔﻰ ﭘﺮﺳﺸﻨﺎﻣﻪ ﺷﺨﺼﻴﺖ ﻧﺌﻮ‪ ،5‬ﻛﻪ ﺑﻪ ﻋﻨﻮﺍﻥ ﻣﻘﻴﺎﺳﻲ ﺟﻬﺖ ﺳﻨﺠﺶ‬
‫ﻣﻴﺰﺍﻥ ﺍﻓﺴﺮﺩﮔﻲ ﻣﻮﺭﺩ ﺍﺳﺘﻔﺎﺩﻩ ﻗﺮﺍﺭ ﮔﺮﻓﺘﻪ ﺑﻮﺩ‪ ،‬ﺑﻪ ﺻﻮﺭﺕ ﻣﻌﻜﻮﺱ ﺑﺎ ﺳﻄﺢ‬
‫ﻛﻠﻰ ﻛﻠﺴﺘﺮﻭﻝ ﺧﻮﻥ ﻫﻤﺴﺒﺘﮕﻰ ﺩﺍﺷﺘﻨﺪ‪ .‬ﻫﻤﺒﺴﺘﮕﻲ ﻣﺸﺎﻫﺪﻩ ﺷﺪﻩ ﺑﻌﺪ ﺍﺯ‬
‫ﺗﻌﺪﻳﻞ ﺩﺭ ﺭﺍﺑﻄﻪ ﺑﺎ ﺳﻦ‪ ،‬ﺷﺎﺧﺺ ﭼﮕﺎﻟﻰ ﺑﺪﻥ‪ ،6‬ﻓﻌﺎﻟﻴﺖ ﺑﺪﻧﻰ‪ ،‬ﺧﺸﻮﻧﺖ ﻭ‬
‫ﺍﺳﺘﻔﺎﺩﻩ ﺍﺯ ﺩﺍﺭﻭﻫﺎﻯ ﺿﺪ ﺣﺎﻣﻠﮕﻰ ﻫﻢﭼﻨﺎﻥ ﻣﻌﻨﺎﺩﺍﺭ ﺑﻮﺩ‪ .‬ﻫﻮﺍﻧﮓ ﻭ ﻫﻤﻜﺎﺭﺍﻧﺶ‬
‫)ﻫﻮﺍﻧﮓ‪ ،‬ﻭﻭ‪ ،‬ﺷﻴﺎﻧﮓ ﻭ ﺷﻦ ‪ (2003،‬ﻧﻴﺰ ﺩﺭ ﻣﻄﺎﻟﻌﺎﺕ ﺧﻮﻳﺶ ﺑﻪ ﺑﺮﺭﺳﻰ ﺭﺍﺑﻄﻪ‬
‫ﻣﻴﺎﻥ ﻏﻠﻈﺖ ﭼﺮﺑﻰﻫﺎ ﻭ ﻟﻴﭙﻮﭘﺮﺗﺌﻴﻦﻫﺎﻯ ﺧﻮﻥ ﺑﺎ ﻭﺿﻌﻴﺖ ﺍﺿﻄﺮﺍﺑﻰ‪ ،‬ﺍﻓﺴﺮﺩﮔﻰ‬
‫ﻭ ﺍﺧﺘﻼﻝ ﺍﻓﺴﺮﺩﮔﻰ ﺍﺳﺎﺳﻰ ﭘﺮﺩﺍﺧﺘﻨﺪ‪ .‬ﻧﺘﺎﻳﺞ ﺗﺤﻘﻴﻖ ﺍﻳﻦ ﻣﺤﻘﻘﻴﻦ ﻧﺸﺎﻥ‬
‫ﻣﻲﺩﺍﺩ ﻛﻪ ﺳﻄﻮﺡ ﻟﻴﭙﻮﭘﺮﻭﺗﺌﻴﻦﻫﺎ ﺑﺎ ﭼﮕﺎﻟﻲ ﺑﺎﻻ )‪ (HDL‬ﻭ ﻧﺴﺒﺖ ﺳﻄﺢ‬
‫ﻛﻠﻲ ﻛﻠﺴﺘﺮﻭﻝ ﺑﻪ ﻟﻴﭙﻮﭘﺮﻭﺗﺌﻴﻦﻫﺎ ﺑﺎ ﭼﮕﺎﻟﻲ ﺯﻳﺎﺩ )‪ (TC/HDL‬ﻫﻤﻴﻨﻄﻮﺭ‬
‫ﻧﺴﺒﺖ ﻟﻴﭙﻮﭘﺮﻭﺗﺌﻴﻦ ﺑﺎ ﭼﮕﺎﻟﻰ ﻛﻢ ))‪ (LDL‬ﺑﻪ ﻟﻴﭙﻮﭘﺮﻭﺗﺌﻴﻦﻫﺎ ﺑﺎ ﭼﮕﺎﻟﻲ ﺯﻳﺎﺩ‬
‫) ‪ ( HDL‬ﺩﺭ ﺑﻴﻤﺎﺭﺍﻥ ﻣﺒﺘﻼ ﺑﻪ ﺍﻓﺴﺮﺩﮔﻰ ﺍﺳﺎﺳﻰ ﺩﺭ ﻣﻘﺎﻳﺴﻪ ﺑﺎ ﮔﺮﻭﻩ ﻛﻨﺘﺮﻝ‬
‫ﺗﻔﺎﻭﺕ ﻣﻌﻨﺎﺩﺍﺭﻯ ﺩﺍﺷﺘﻨﺪ‪ .‬ﻻﺯﻡ ﺑﻪ ﺫﻛﺮ ﺍﺳﺖ ﻛﻪ ﺗﻤﺎﻣﻰ ﻣﻄﺎﻟﻌﺎﺕ ﺍﻧﺠﺎﻡ ﺷﺪﻩ‬
‫ﻧﺸﺎﻥ ﺩﻫﻨﺪﻩ ﻭﺟﻮﺩ ﺭﺍﺑﻄﻪ ﻣﻴﺎﻥ ﻛﻠﺴﺘﺮﻭﻝ ﻭ ﺍﻓﺴﺮﺩﮔﻰ ﻧﻤﻰﺑﺎﺷﻨﺪ‪.‬‬
‫ﺑﻪ ﻣﻮﺍﺯﺍﺕ ﺗﺤﻘﻴﻘﺎﺗﻲ ﻛﻪ ﻃﻲ ﺩﻫﻪ ﮔﺬﺷﺘﻪ ﺑﻪ ﺑﺮﺭﺳﻲ ﺭﺍﺑﻄﻪ ﻣﻴﺎﻥ ﺳﻄﻮﺡ‬
‫ﻛﻠﺴﺘﺮﻭﻝ ﻳﺎ ﻟﻴﭙﻮﭘﺮﻭﺗﺌﻴﻦﻫﺎﻱ ﺧﻮﻥ ﺑﺎ ﻣﻴﺰﺍﻥ ﺍﻓﺴﺮﺩﮔﻲ ﭘﺮﺩﺍﺧﺘﻪﺍﻧﺪ‪ ،‬ﻣﻄﺎﻟﻌﺎﺕ‬
‫ﻣﺨﺘﻠﻔﻰ ﻣﺘﻨﺎﻭﺑ ًﺎ ﻧﺸﺎﻥ ﺩﻫﻨﺪﻩ ﻧﺸﺎﻧﻪﻫﺎﻱ ﺍﻓﺴﺮﺩﮔﻲ ﭘﻴﺶ ﺍﺯ ﺩﺭﻣﺎﻥ ﺩﺭ‬
‫ﺑﻴﻤﺎﺭﺍﻥ ﻣﺒﺘﻼ ﺑﻪ ﻫﻴﭙﺮﺗﺮﻱﮔﻠﻴﺴﻴﺮﻳﺪﻣﻴﺎﻱ ﻓﺎﻣﻴﻠﻲ‪ 7‬ﺑﻮﺩﻩﺍﻧﺪ )ﮔﻠﻮﻙ‪ ،‬ﻓﻼﺕ‪،‬‬
‫‪6- body mass index‬‬
‫‪7- fmilial hypertriglycidemia‬‬
‫‪8- emotional‬‬
‫‪9- low density lipoprotein‬‬
‫‪10- high density lipoprotein‬‬
 ‫ﺑﺮﺭﺳﻰ ﺭﺍﺑﻄﻪ ﺳﻄﻮﺡ ﭼﺮﺑﻲﻫﺎ ﻭ ﻟﻴﭙﻮﭘﺮﻭﺗﺌﻲﻫﺎﻱ ﺧﻮﻥ ﺑﺎ ﺍﻓﺴﺮﺩﮔﻲ‬

‫ﺟﺪﻭﻝ ‪ -1‬ﻣﻴﺎﻧﮕﻴﻦ ﻭ ﺍﻧﺤﺮﺍﻑ ﻣﻌﻴﺎﺭ ﻣﺘﻐﻴﺮﻫﺎﻱ ﻓﻴﺰﻳﻮﻟﻮژﻳﻚ ﻭ ﺍﻓﺴﺮﺩﮔﻲ‬

‫ﺍﻧﺤﺮﺍﻑ ﻣﻌﻴﺎﺭ‬ ‫ﻣﻴﺎﻧﮕﻴﻦ‬ ‫ﻣﺘﻐﻴﺮﻫﺎ‬ ‫ﺷﻤﺎﺭﻩ‬

‫‪8/3‬‬ ‫‪34/2‬‬ ‫ﺳﻦ‬ ‫‪1‬‬

‫‪8/8‬‬ ‫‪10/47‬‬ ‫ﺍﻓﺴﺮﺩﮔﻲ‬ ‫‪2‬‬
‫‪39/2‬‬ ‫‪197/14‬‬ ‫ﻛﻠﺴﺘﺮﻭﻝ‬ ‫‪3‬‬
‫‪39‬‬ ‫‪189/1‬‬ ‫ﺗﺮﻱﮔﻠﻴﺴﻴﺮﻳﺪ‬ ‫‪4‬‬
‫‪6/7‬‬ ‫‪151/2‬‬ ‫ﻟﻴﭙﻮﭘﺮﻭﺗﺌﻴﻦﻫﺎ ﺑﺎ ﭼﮕﺎﻟﻲ ﻛﻢ‬ ‫‪5‬‬
‫‪7/6‬‬ ‫‪33/4‬‬ ‫ﻟﻴﭙﻮﭘﺮﻭﺗﺌﻴﻦﻫﺎ ﺑﺎ ﭼﮕﺎﻟﻲ ﺯﻳﺎﺩ‬ ‫‪6‬‬

‫ﺍﻓﺮﺍﺩ ﺩﺭ ﻭﺿﻌﻴﺖ ﻏﻴﺮ ﺑﻴﻤﺎﺭ ﺑﻮﺩ ﻛﻪ ﺑﻪ ﺩﻟﻴﻞ ﺍﺭﺯﻳﺎﺑﻲﻫﺎﻳﻲ ﺍﺟﺒﺎﺭﻱ ﺍﻧﺠﺎﻡ‬
‫ﺷﺪﻩ ﺩﺭ ﺭﺍﺑﻄﻪ ﺑﺎ ﺗﻤﺎﻣﻲ ﭘﺮﺳﻨﻞ ﺷﺎﻏﻞ ﺩﺭ ﻣﺠﻤﻮﻋﻪ ﻛﺎﺭﻱ ﺍﻳﻦ ﺷﺮﻛﺖ‪،‬‬
‫ﺑﺮﺍﻱ ﻣﺤﻘﻖ ﻓﺮﺍﻫﻢ ﮔﺮﺩﻳﺪ‪ .‬ﺍﺯ ﻃﺮﻑ ﺩﻳﮕﺮ ﺩﺳﺘﺮﺳﻲ ﺳﻬﻞﺗﺮ ﺑﻪ ﭘﺮﺳﻨﻞ‬
‫ﻭ ﺍﻧﺘﺨﺎﺏ ﻧﻤﻮﻧﻪ ﺍﺯ ﺑﻴﻦ ﺍﻓﺮﺍﺩ ﻭ ﻣﻬﻤﺘﺮ ﺍﺯ ﻫﻤﻪ ﻣﺴﺘﻨﺪ ﺑﻮﺩﻥ ﺍﻃﻼﻋﺎﺕ‬
‫ﻣﻮﺟﻮﺩ ﺩﺭ ﭘﺮﻭﻧﺪﻫﺎﻯ ﺁﻧﻬﺎ‪ ،‬ﺟﺎﻣﻌﻪ ﺣﺎﺿﺮ ﺭﺍ ﺩﺭ ﺑﻴﻦ ﺟﻮﺍﻣﻊ ﻣﻮﺟﻮﺩ ﺑﺮﺍﻱ‬
‫ﭘﺎﺳﺨﮕﻮﻳﻲ ﺑﻪ ﺳﻮﺍﻻﺕ ﺍﻳﻦ ﭘﮋﻭﻫﺶ ﺍﻳﺪﻩﺍﻝ ﻣﻲ ﻧﻤﺎﻳﺎﻧﺪ‪ .‬ﭘﺲ ﺍﺯ ﻫﻤﺎﻫﻨﮕﻲ‬
‫ﺑﺎ ﻣﺴﺌﻮﻟﻴﻦ ﺁﺯﻣﺎﻳﺸﮕﺎﻩ ﺷﺮﻛﺖ ﻭ ﺩﺭ ﺍﺧﺘﻴﺎﺭ ﮔﺮﻓﺘﻦ ﻟﻴﺴﺖ ﺍﻓﺮﺍﺩ ﻭ ﻣﺸﺨﺺ‬
‫ﺷﺪﻥ ﻧﻤﻮﻧﻪ‪ ،‬ﭘﻴﺶ ﺍﺯ ﺍﻧﺠﺎﻡ ﺁﺯﻣﺎﻳﺶ ﺧﻮﻥ ﺍﺯ ﺷﺮﻛﺖ ﻛﻨﻨﺪﮔﺎﻥ ﺩﺭ ﭘﮋﻭﻫﺶ‬
‫ﺩﻋﻮﺕ ﮔﺮﺩﻳﺪ ﺗﺎ ﺑﺎ ﭘﺮ ﻛﺮﺩﻥ ﭘﺮﺳﺸﻨﺎﻣﻪ ﺧﻮﺩﺳﻨﺠﻲ ﺍﻓﺴﺮﺩﮔﻲ ﺑﻚ ﺑﺎ ﻣﺤﻘﻖ‬
‫ﺟﻬﺖ ﺍﻧﺠﺎﻡ ﻳﻚ ﺗﺤﻘﻴﻖ ﻫﻤﻜﺎﺭﻱ ﻧﻤﺎﻳﻨﺪ‪ .‬ﺑﺪﻳﻦ ﺗﺮﺗﻴﺐ ﺩﺍﺩﻩﻫﺎﻱ ﻻﺯﻡ‬
‫ﺟﻬﺖ ﺍﺭﺯﻳﺎﺑﻲ ﻣﻴﺰﺍﻥ ﺍﻓﺴﺮﺩﮔﻲ ﺷﺮﻛﺖ ﻛﻨﻨﺪﮔﺎﻥ ﻓﺮﺍﻫﻢ ﮔﺮﺩﻳﺪ‪ .‬ﺑﻌﺪ ﺍﺯ ﺍﻳﻦ‬
‫ﻣﺮﺣﻠﻪ ﺑﺎ ﻫﻤﻜﺎﺭﻱ ﺁﺯﻣﺎﻳﺸﮕﺎﻩ ﻧﺘﺎﻳﺞ ﺁﺯﻣﺎﻳﺸﮕﺎﻫﻲ ﻣﺮﺑﻮﻁ ﺑﻪ ﭼﺮﺑﻲﻫﺎ ﻭ‬
‫ﻟﻴﭙﻮﭘﺮﻭﺋﻴﻦﻫﺎﻱ ﺧﻮﻥ ﻛﻪ ﻋﺒﺎﺭﺕ ﺑﻮﺩﻧﺪ ﺍﺯ‪ :‬ﺳﻄﻮﺡ ﻛﻠﺴﺘﺮﻭﻝ‪ ،‬ﻟﻴﭙﻮﭘﺮﻭﺗﺌﻴﻦﻫﺎ‬
‫ﺑﺎ ﭼﻜﺎﻟﻰ ﺯﻳﺎﺩ )‪ (HDL‬ﻭ ﻛﻢ )‪ (LDL‬ﻭ ﺗﺮﻱﮔﻠﻴﺴﻴﺮﻳﺪ ﺧﻮﻥ ﻧﻴﺰ ﺟﻬﺖ‬
‫ﺑﺮﺭﺳﻲ ﻭ ﺗﺤﻠﻴﻞ ﻓﺮﺿﻴﺎﺕ ﻣﻄﺮﺡ ﺷﺪﻩ ﺩﺭ ﺍﺧﺘﻴﺎﺭ ﻣﺤﻘﻖ ﻗﺮﺍﺭ ﮔﺮﻓﺖ‪.‬‬
‫ﺍﺑﺰﺍﺭ ﺳﻨﺠﺶ‬
‫ﻣﻘﻴﺎﺱ ﺍﻓﺴﺮﺩﮔﻲ ﺑﻚ‪ -‬ﺍﻳﻦ ﻣﻘﻴﺎﺱ ﻳﻚ ﺁﺯﻣﻮﻥ ‪ 21‬ﺳﺆﺍﻟﻲ ﺍﺳﺖ ﻛﻪ‬
‫ﺷﺪﺕ ﻧﺸﺎﻧﻪﻫﺎﻱ ﺍﻓﺴﺮﺩﮔﻲ ﺭﺍ ﺩﺭ ﻣﻘﻴﺎﺱ ﭼﻬﺎﺭ ﺩﺭﺟﻪﺍﻱ ﻟﻴﻜﺮﺕ ﺍﺯ ﻧﻤﺮﻩ‬
‫‪ 0‬ﺗﺎ ‪ 63‬ﻣﻲﺳﻨﺠﺪ‪ .‬ﺍﻳﻦ ﻣﻘﻴﺎﺱ ﻳﻜﻲ ﺍﺯ ﺍﺑﺰﺍﺭﻫﺎﻱ ﻣﻌﺘﺒﺮ ﺑﺮﺍﻱ ﺳﻨﺠﺶ‬
‫ﺷﺪﺕ ﻧﺸﺎﻧﻪﻫﺎﻱ ﺍﻓﺴﺮﺩﮔﻲ ﻣﺤﺴﻮﺏ ﻣﻲﺷﻮﺩ ﻭ ﭘﺎﻳﺎﻳﻲ ﻭ ﺍﻋﺘﺒﺎﺭ ﺁﻥ ﺩﺭ‬
‫ﻭﺿﻌﻴﺖ ﻃﺒﻴﻌﻲ ﻭ ﺭﻭﺯﻣﺮﻩ ﺑﺎ ﻣﻴﺰﺍﻥ ﺍﻓﺴﺮﺩﮔﻲ ﺍﻓﺮﺍﺩ‪ ،‬ﺩﺭﺣﺎﻟﻴﻜﻪ ﺗﺎﺛﻴﺮﺍﺗﺸﺎﻥ‬
‫ﺑﺮﻳﻜﺪﻳﮕﺮ ﻣﺪ ﻧﻈﺮ ﻗﺮﺍﺭ ﻣﻰﮔﻴﺮﺩ‪ ،‬ﺭﺍﺑﻄﻪﺍﻱ ﻭﺟﻮﺩ ﺩﺍﺭﺩ‪ ،‬ﻭ ﭼﻨﺎﻧﭽﻪ ﺭﺍﺑﻄﻪﺍﻱ‬
‫ﺢ ﺍﺳﺖ ﻛﻪ ﺑﺎ ﺩﺭﺩﺳﺖ‬ ‫ﻭﺟﻮﺩ ﺩﺍﺭﺩ ﻛﻴﻔﻴﺖ ﺁﻥ ﺑﻪ ﭼﻪ ﻧﺤﻮﻱ ﺍﺳﺖ‪ .‬ﭘﺮ ﻭﺍﺿﺢ‬
‫ﺩﺍﺷﺘﻦ ﺍﻃﻼﻋﺎﺗﻲ ﺭﺍﺟﻊ ﺑﻪ ﺭﻭﺍﺑﻂ ﺍﺣﺘﻤﺎﻟﻲ ﻣﻴﺎﻥ ﭼﺮﺑﻲﻫﺎ ﻭ ﻟﻴﭙﻮﭘﺮﻭﺗﺌﻴﻦﻫﺎﻱ‬
‫ﺧﻮﻥ ﻭ ﻣﻴﺰﺍﻥ ﺍﻓﺴﺮﺩﮔﻲ ﺩﺭ ﺍﻓﺮﺍﺩ ﺩﺭ ﺍﻭﻟﻴﻦ ﮔﺎﻡ ﻣﻲﺗﻮﺍﻥ ﺍﻃﻼﻋﺎﺗﻲ ﺑﻪ‬
‫ﺩﺍﻧﺶ ﻓﻌﻠﻲ ﺭﺍﺟﻊ ﺑﻪ ﻋﻠﻞ ﭘﺪﻳﺪﺁﻳﻲ ﺍﻓﺴﺮﺩﮔﻲ ﺍﺯ ﺩﻳﺪﮔﺎﻩ ﺯﻳﺴﺖﺷﻨﺎﺧﺘﻲ‬
‫ﺍﻓﺰﻭﺩ ﻭ ﺩﺭ ﮔﺎﻡ ﺑﻌﺪ ﻣﻲﺗﻮﺍﻥ ﺑﻪ ﻃﺮﺍﺣﻲ ﺍﻗﺪﺍﻣﺎﺕ ﭘﻴﺸﮕﻴﺮﺍﻧﻪ ﺩﺭ ﺑﺎﺏ ﺍﺛﺮﺍﺕ‬
‫ﻣﻨﻔﻲ ﻭ ﻧﺎﺧﻮﺍﺳﺘﻪ ﺳﻄﻮﺡ ﻛﻠﺴﺘﺮﻭﻝ‪ ،‬ﺗﺮﻱﮔﻠﻴﺴﻴﺮﻳﺪ ﻭ ﻟﻴﭙﻮﭘﺮﻭﺗﺌﻴﻦﻫﺎﻱ‬
‫ﺧﻮﻥ ﭘﺮﺩﺍﺧﺖ‪ .‬ﺍﻳﻦ ﭘﮋﻭﻫﺶ ﺑﺎ ﺍﺳﺘﻔﺎﺩﻩ ﺍﺯ ﺭﻭﺵﻫﺎﻱ ﭘﻴﭽﻴﺪﻩﺗﺮ ﺁﻣﺎﺭﻱ ﻧﻈﻴﺮ‬
‫ﺭﮔﺮﺳﻴﻮﻥ ﭼﻨﺪ ﻣﺘﻐﻴﺮﻩ ﻭ ﺩﺭ ﻧﻈﺮ ﮔﺮﻓﺘﻦ ﻣﺘﻐﻴﻴﺮﻫﺎﻱ ﻣﺨﺘﻠﻒ ﻧﻈﻴﺮ ﺳﻄﻮﺡ‬
‫ﻛﻠﺴﺘﺮﻭﻝ‪ ،‬ﺗﺮﻱﮔﻠﻴﺴﻴﺮﻳﺪ ﻭ ﻟﻴﭙﻮﭘﺮﻭﺗﺌﻴﻦﻫﺎﻱ ﺧﻮﻥ ﺑﻪ ﺻﻮﺭﺕ ﺗﺮﻛﻴﺒﻰ ﺑﺎ‬
‫ﻣﻴﺰﺍﻥ ﺍﻓﺴﺮﺩﮔﻲ‪ ،‬ﺍﻳﻦ ﻣﻮﺿﻮﻉ ﺭﺍ ﺍﺯ ﺩﻳﺪﮔﺎﻫﻰ ﺟﺪﻳﺪ ﻣﻮﺭﺩ ﺑﺮﺭﺳﻲ ﻭ ﻣﻄﺎﻟﻌﻪ‬ ‫‪26‬‬
‫ﻗﺮﺍﺭ ﺩﺍﺩﻩ ﺍﺳﺖ‪.‬‬
‫ﺭﻭﺵ‬
‫ﺟﺎﻣﻌﻪ ﺁﻣﺎﺭﻯ‪ ،‬ﻧﻤﻮﻧﻪ ﻭ ﺭﻭﺵ ﺍﺟﺮﺍﻯ ﭘﮋﻭﻫﺶ‬
‫ﺍﺯﻣﻴﺎﻥ ﻛﻠﻴﻪ ﻣﺮﺍﺟﻌﻴﻦ ﺑﻪ ﺁﺯﻣﺎﻳﺸﮕﺎﻩ ﻣﺴﺘﻘﺮﺩﺭ ﻳﻚ ﺷﺮﻛﺖ ﺑﺰﺭگ ﺻﻨﻌﺘﻰ‬
‫ﺗﻌﺪﺍﺩ ‪ 200‬ﻧﻔﺮ ﺑﻪ ﺻﻮﺭﺕ ﺗﺼﺎﺩﻓﻲ ﺟﻬﺖ ﻣﺸﺎﺭﻛﺖ ﺩﺭ ﺍﻳﻦ ﭘﮋﻭﻫﺶ‬
‫ﺍﻧﺘﺨﺎﺏ ﮔﺮﺩﻳﺪ‪ .‬ﻋﻠﺖ ﺍﻧﺘﺨﺎﺏ ﺍﻳﻦ ﻣﺠﻤﻮﻋﻪ ﺑﻪ ﻋﻨﻮﺍﻥ ﺟﺎﻣﻌﻪ ﭘﮋﻭﻫﺶ‪ ،‬ﺩﺭ‬
‫ﻭﺍﻗﻊ ﺍﻣﻜﺎﻥ ﻛﻨﺘﺮﻝ ﺑﻴﺸﺘﺮ ﺑﺮ ﺭﻭﻱ ﻣﺘﻐﻴﺮﻫﺎﻳﻲ ﻧﻈﻴﺮ ﺍﻋﺘﻴﺎﺩ ﺑﻪ ﺍﻟﻜﻞ ﻭ ﻣﻮﺍﺩ‬
‫ﻣﺨﺪﺭ‪ ،‬ﺑﻴﻤﺎﺭﻱﻫﺎﻱ ﺧﻮﻧﻲ ﻭ ﻗﻠﺒﻲ ﻋﺮﻭﻗﻲ ﻭ ﻣﻬﻤﺘﺮ ﺍﺯ ﻫﻤﻪ ﺍﻣﻜﺎﻥ ﺑﺮﺭﺳﻰ‬

‫ﺟﺪﻭﻝ ‪ -2‬ﻣﻴﺎﻧﮕﻴﻦ ﻭ ﺍﻧﺤﺮﺍﻑ ﻣﻌﻴﺎﺭ ﻣﺘﻐﻴﺮﻫﺎﻱ ﻓﻴﺰﻳﻮﻟﻮژﻳﻚ ﻭ ﺍﻓﺴﺮﺩﮔﻲ‬

‫‪6‬‬ ‫‪5‬‬ ‫‪4‬‬ ‫‪3‬‬ ‫‪2‬‬ ‫‪1‬‬ ‫ﻣﺘﻐﻴﺮﻫﺎ‬ ‫ﺷﻤﺎﺭﻩ‬

‫ﺍﻓﺴﺮﺩﮔﻰ‬
‫‪-‬‬ ‫‪1‬‬
‫ﻛﻠﺴﺘﺮﻭﻝ‬
‫‪-‬‬ ‫**‪-0/178‬‬ ‫‪2‬‬
‫ﺗﺮﻯﮔﻠﻴﺴﻴﺮﻳﺪ‬
‫‪-‬‬ ‫‪0/237‬‬ ‫‪0/034‬‬ ‫‪3‬‬
‫ﻟﻴﭙﻮﭘﺮﻭﺗﺌﻴﻦ ﺑﺎ ﭼﮕﺎﻟﻰ ﻛﻢ‬
‫‪-‬‬ ‫**‪-0/279‬‬ ‫‪0/043‬‬ ‫‪-0/017‬‬ ‫‪4‬‬
‫ﻟﻴﭙﻮﭘﺮﻭﺗﺌﻴﻦ ﺑﺎ ﭼﮕﺎﻟﻰ ﺯﻳﺎﺩ‬
‫‪-‬‬ ‫‪0/17‬‬ ‫‪0/18‬‬ ‫**‪-0/251‬‬ ‫**‪-0/219‬‬ ‫‪5‬‬
‫ﺳﻦ‬
‫‪-‬‬ ‫‪-0/128‬‬ ‫‪0/073‬‬ ‫‪-0/015‬‬ ‫‪0/209‬‬ ‫**‪-0/276‬‬ ‫‪6‬‬
‫**‬
‫‪p<0/001‬‬
 ‫ﻃﺒﺎﻃﺒﺎﺋﻲ ﻭ ﻫﻤﻜﺎﺭﺍﻥ‬

‫ﺟﺪﻭﻝ ‪ - 3‬ﺭﮔﺮﺳﻴﻮﻥ ﻫﻤﺰﻣﺎﻥ ﻣﻴﺰﺍﻥ ﺍﻓﺴﺮﺩﮔﻰ ﺍﺯ ﺭﻭﻯ ﺳﻄﻮﺡ ﻛﻠﺴﺘﺮﻭﻝ‪ ،‬ﺗﺮﻯﮔﻠﻴﺴﻴﺮﻳﺪ ﻭ ﻟﻴﭙﻮﭘﺮﻭﺗﺌﻴﻦﻫﺎ ﺑﺎ ﭼﮕﺎﻟﻰ ﻛﻢ ﻭ ﺯﻳﺎﺩ‬

‫ﻟﻴﭙﻮﭘﺮﻭﺗﺌﻴﻦ ﺑﺎ‬ ‫ﻟﻴﭙﻮﭘﺮﻭﺗﺌﻴﻦ ﺑﺎ‬ ‫ﻣﺘﻐﻴﺮﻫﺎﻯ ﭘﻴﺶ ﺑﻴﻦ‬

‫‪F‬‬ ‫‪R‬‬ ‫‪df‬‬ ‫ﺗﺮﻳﮕﻠﻴﺴﻴﺮﻳﺪ‬ ‫ﻛﻠﺴﺘﺮﻭﻝ‬
‫ﭼﮕﺎﻟﻰ ﺯﻳﺎﺩ‬ ‫ﭼﮕﺎﻟﻰ ﻛﻢ‬ ‫ﻣﺘﻐﻴﺮ ﻣﻼﻙ‬

‫‪6/44‬‬ ‫‪0/12‬‬ ‫‪ 188‬ﻭ‪4‬‬ ‫‪-0/29‬‬ ‫‪0/06‬‬ ‫‪0/06‬‬ ‫‪-0/28‬‬ ‫ﻣﻴﺰﺍﻥ ﺍﻓﺴﺮﺩﮔﻰ‬

‫**‬
‫‪p<0/001‬‬

‫ﺑﺪﻳﻦ ﺗﺮﺗﻴﺐ ﺗﺎﺛﻴﺮﺷﺎﻥ ﺑﺮ ﻣﻴﺰﺍﻥ ﺍﻓﺴﺮﺩﮔﻲ ﻛﻨﺘﺮﻝ ﮔﺮﺩﻳﺪﻩ ﻭ ﺩﺭ ﮔﺎﻡ ﭼﻬﺎﺭﻡ‬
‫ﻛﻠﺴﺘﺮﻭﻝ ﻭﺍﺭﺩ ﻣﻌﺎﺩﻟﻪ ﮔﺮﺩﻳﺪ‪ ،‬ﻣﻄﺎﺑﻖ ﺟﺪﻭﻝ ‪ 1‬ﻭ ‪ 2‬ﻧﺘﺎﻳﺞ ﺭﮔﺮﺳﻴﻮﻥ ﺳﻠﺴﻠﻪ‬
‫ﻣﺮﺍﺗﺒﻲ ﺑﺮﺍﻱ ﺗﻌﻴﻴﻦ ﺗﺎﺛﻴﺮ ﻣﻴﺰﺍﻥ ﻛﻠﺴﺘﺮﻭﻝ ﺧﻮﻥ ﺑﺮ ﺍﻓﺴﺮﺩﮔﻲ ﻓﺮﺍﺗﺮ ﺍﺯ‬
‫ﺳﻄﻮﺡ ﺗﺮﻱﮔﻠﻴﺴﻴﺮﻳﺪ ﻭ ﻟﻴﭙﻮﭘﺮﻭﺗﺌﻴﻦﻫﺎﻱ ﺧﻮﻥ ﺁﺷﻜﺎﺭ ﻣﻲﺑﺎﺷﺪ‪.‬‬
‫ﺟﺪﻭﻝ ﺷﻤﺎﺭﻩ ‪ 3‬ﻧﺘﺎﻳﺞ ﺣﺎﺻﻞ ﺍﺯ ﺍﻧﺠﺎﻡ ﺭﮔﺮﺳﻴﻮﻥ ﻫﻤﺰﻣﺎﻥ ﻣﻴﺰﺍﻥ‬
‫ﺍﻓﺴﺮﺩﮔﻰ ﺍﺯ ﺭﻭﻯ ﺳﻄﻮﺡ ﻛﻠﺴﺘﺮﻭﻝ‪ ،‬ﺗﺮﻯﮔﻠﻴﺴﻴﺮﻳﺪ ﻭ ﻟﻴﭙﻮﭘﺮﻭﺗﺌﻴﻦﻫﺎ ﺑﺎ‬
‫ﭼﮕﺎﻟﻰ ﭘﺎﻳﻴﻦ ﻭ ﺑﺎﻻ ﺭﺍ ﻧﺸﺎﻥ ﻣﻰ ﺩﻫﻨﺪ‪.‬‬
‫ﭘﮋﻭﻫﺶﻫﺎﻱ ﻣﺘﻌﺪﺩ ﺗﺎﻳﻴﺪ ﺷﺪﻩ ﺍﺳﺖ )ﺑﻚ‪ ،‬ﺭﺍﺵ‪ ،‬ﺷﺎﻭ ﻭ ﺍﻣﺮﻱ‪;1979 ،‬‬
‫ﺑﻚ‪ ،‬ﺍﺳﺘﻴﺮ ﻭ ﮔﺎﺭﺑﻴﻦ‪.(1988 ،‬‬
‫ﻳﺎﻓﺘﻪﻫﺎ‬
‫ﻣﻴﺎﻧﮕﻴﻦ ﻭ ﺍﻧﺤﺮﺍﻑ ﻣﻌﻴﺎﺭ ﻣﺘﻐﻴﺮﻫﺎﻱ ﭘﮋﻭﻫﺶ ﻛﻪ ﻣﺮﺑﻮﻁ ﺑﻪ ﺗﻮﺻﻴﻒ‬
‫ﺍﻃﻼﻋﺎﺕ ﺩﺭ ﺧﺼﻮﺹ ﻣﺘﻐﻴﺮﻫﺎﻱ ﻓﻴﺰﻳﻮﻟﻮژﻳﻚ ﻭ ﻣﺘﻐﻴﺮ ﻣﻴﺰﺍﻥ ﺍﻓﺴﺮﺩﮔﻲ‬
‫ﺑﺮﺍﺳﺎﺱ ﺁﺯﻣﻮﻥ ﺑﻚ ﻣﻲﺑﺎﺷﺪ ﺩﺭ ﺟﺪﻭﻝ‪ 1-4‬ﺍﺭﺍﺋﻪ ﮔﺮﺩﻳﺪﻩ ﺍﺳﺖ‪.‬‬

‫ﺟﺪﻭﻝ ‪ -4‬ﺭﮔﺮﺳﻴﻮﻥ ﺳﻠﺴﻠﻪ ﻣﺮﺍﺗﺒﻰ ﻣﻴﺰﺍﻥ ﺍﻓﺴﺮﺩﮔﻰ ﺍﺯ ﺭﻭﻯ ﻣﺘﻐﻴﺮﻫﺎﻯ ﺳﻄﻮﺡ ﻛﻠﺴﺘﺮﻭﻝ‪ ،‬ﺗﺮﻯﮔﻠﻴﺴﻴﺮﻳﺪ‪،‬‬
‫ﻟﻴﭙﻮﭘﺮﻭﺗﺌﻴﻦﻫﺎ ﺑﺎ ﭼﮕﺎﻟﻰ ﻛﻢ ﻭ ﺯﻳﺎﺩ ﻓﺮﺍﺗﺮ ﺍﺯ ﻣﺘﻐﻴﺮ ﺳﻦ‬

‫‪β‬‬ ‫‪∆F‬‬ ‫‪∆R‬‬ ‫‪R‬‬ ‫‪df‬‬ ‫ﻣﻴﺰﺍﻥ ﺍﻓﺴﺮﺩﮔﻲ ﻣﺘﻐﻴﺮﻫﺎ‬

‫‪-0/277‬‬ ‫‪15/73‬‬ ‫‪-‬‬ ‫‪0/076‬‬ ‫‪191‬ﻭ‪1‬‬ ‫ﮔﺎﻡ ﺍﻭﻝ ﺳﻦ‬

‫‪27‬‬ ‫‪0/044‬‬ ‫‪6/21‬‬ ‫‪0/107‬‬ ‫‪0/183‬‬ ‫‪187‬ﻭ‪4‬‬ ‫ﮔﺎﻡ ﺩﻭﻡ ﺗﺮﻯ ﮔﻠﻴﺴﻴﺮﻳﺪ‬

‫‪-0/315‬‬ ‫ﻟﻴﭙﻮﭘﺮﻭﺗﺌﻴﻦ ﻫﺎ ﺑﺎ ﭼﮕﺎﻟﻲ ﺯﻳﺎﺩ‬

‫‪0/083‬‬ ‫ﻟﻴﭙﻮﭘﺮﻭﺗﺌﻴﻦ ﻫﺎ ﺑﺎ ﭼﮕﺎﻟﻰ ﻛﻢ‬

‫‪-0/212‬‬ ‫ﻭ ﻛﻠﺴﺘﺮﻭﻝ‬
‫**‬ ‫***‬
‫‪p<0/001‬‬ ‫‪p <0/0001‬‬

‫ﻫﻤﺎﻥ ﻃﻮﺭ ﻛﻪ ﺩﺭ ﺟﺪﻭﻝ ﺷﻤﺎﺭﻩ ‪ 3‬ﻧﺸﺎﻥ ﺩﺍﺩﻩ ﺷﺪﻩ ﺍﺳﺖ ﺑﻴﻦ ﻣﻴﺰﺍﻥ‬
‫ﺍﻓﺴﺮﺩﮔﻰ ﻭ ﺳﻄﻮﺡ ﻛﻠﺴﺘﺮﻭﻝ‪ ،‬ﺗﺮﻯﮔﻠﻴﺴﻴﺮﻳﺪ‪ ،‬ﻟﻴﭙﻮﭘﺮﻭﺗﺌﻴﻦ ﺑﺎ ﭼﮕﺎﻟﻰ ﻛﻢ‬
‫ﻭ ﺯﻳﺎﺩ ﺭﺍﺑﻄﻪ ﻣﻌﻨﺎﺩﺍﺭﻯ ﻭﺟﻮﺩ ﺩﺍﺭﺩ‪ .‬ﻣﻘﺪﺍﺭ ‪) R‬ﺿﺮﻳﺐ ﻫﻤﺒﺴﺘﮕﻰ ﭼﻨﺪ‬
‫ﻣﺘﻐﻴﺮﻩ( ﺟﺪﻭﻝ ﻧﺸﺎﻥ ﻣﻰﺩﻫﺪ ﻛﻪ ﺩﺭ ﺍﻳﻦ ﭘﮋﻭﻫﺶ‪ ،‬ﺳﻄﻮﺡ ﻛﻠﺴﺘﺮﻭﻝ‪،‬‬
‫ﺗﺮﻯﮔﻠﻴﺴﻴﺮﻳﺪ‪ ،‬ﻟﻴﭙﻮﭘﺮﻭﺗﺌﻴﻦﻫﺎ ﺑﺎ ﭼﮕﺎﻟﻰ ﻛﻢ )‪ (LDL‬ﻭ ﺯﻳﺎﺩ )‪ (HDL‬ﺩﺭ‬
‫ﻣﺠﻤﻮﻉ ‪ 12‬ﺩﺭﺻﺪ ﺍﺯ ﺗﻐﻴﻴﺮﺍﺕ ﻣﻴﺰﺍﻥ ﺍﻓﺴﺮﺩﮔﻰ ﺭﺍ ﺗﺒﻴﻴﻦ ﻣﻰﻛﻨﻨﺪ‪ .‬ﻛﻪ ﺩﺭ‬
‫ﺳﻄﺢ ‪ P<0/001‬ﻭ ﺑﺎ ‪ F(4,188)=6/44‬ﻣﻌﻨﺎﺩﺍﺭ ﻣﻰﺑﺎﺷﺪ‪.‬‬
‫ﻣﻘﺪﺍﺭ ﺿﺮﻳﺐ ﺭﮔﺮﺳﻴﻮﻥ ﺳﻄﺢ ﻛﻠﺴﺘﺮﻭﻝ ﺧﻮﻥ )‪ (β=-0/28‬ﻛﻪ‬
‫ﺩﺭ ﺳﻄﺢ ‪ P<0/001‬ﻣﻌﻨﺎﺩﺍﺭ ﻣﻰﺑﺎﺷﺪ‪ ،‬ﻧﺸﺎﻥ ﻣﻰﺩﻫﺪ ﻛﻪ ﺩﺭ ﺍﻓﺮﺍﺩﻯ‬
‫ﻛﻪ ﺳﻄﻮﺡ ﻛﻠﺴﺘﺮﻭﻝ ﺧﻮﻥﺷﺎﻥ ﭘﺎﻳﻴﻦ ﺍﺳﺖ ‪ ،‬ﻣﻴﺰﺍﻥ ﺍﻓﺴﺮﺩﮔﻰ ﺑﺎﻻﺗﺮ‬
‫ﺍﺳﺖ‪ .‬ﺿﺮﻳﺐ ﺭﮔﺮﺳﻴﻮﻥ ﺳﻄﺢ ﻟﻴﭙﻮﭘﺮﻭﺗﺌﻴﻦ ﺑﺎ ﭼﮕﺎﻟﻰ ﺯﻳﺎﺩ )‪(HDL‬‬
‫)‪ (β=-0/29‬ﻛﻪ ﺩﺭ ﺳﻄﺢ ‪ P<0/001‬ﻣﻌﻨﺎﺩﺍﺭ ﺍﺳﺖ‪ ،‬ﻧﺸﺎﻥ ﻣﻰﺩﻫﺪ ﻛﻪ‬
‫ﻫﻤﺎﻧﻨﺪ ﺳﻄﺢ ﻛﻠﺴﺘﺮﻭﻝ‪ ،‬ﻫﺮﭼﻪ ﺳﻄﺢ ﻟﻴﭙﻮﭘﺮﻭﺗﺌﻴﻦ ﺑﺎ ﭼﮕﺎﻟﻰ ﺯﻳﺎﺩ ﻛﺎﻫﺶ‬
‫ﻳﺎﺑﺪ ﻣﻴﺰﺍﻥ ﺍﻓﺴﺮﺩﮔﻰ ﺍﻓﺰﺍﻳﺶ ﻣﻰﻳﺎﺑﺪ‪.‬‬
‫ﻫﻤﺎﻥ ﻃﻮﺭ ﻛﻪ ﺩﺭ ﺟﺪﻭﻝ ﻣﺸﺎﻫﺪﻩ ﻣﻰﮔﺮﺩﺩ ﻫﻴﭽﻜﺪﺍﻡ ﺍﺯ ﺩﻭ ﻣﺘﻐﻴﻴﺮ ﺳﻄﺢ‬
‫ﻣﻄﺎﺑﻖ ﺟﺪﻭﻝ ﺷﻤﺎﺭﻩ ‪ 2‬ﺿﺮﺍﻳﺐ ﻫﻤﺒﺴﺘﮕﻲ ﺑﻴﻦ ﺗﻤﺎﻣﻲ ﻣﺘﻐﻴﺮﻫﺎﻱ ﻣﻮﺭﺩ‬
‫ﻣﻄﺎﻟﻌﻪ ﻭ ﺍﻓﺴﺮﺩﮔﻲ ﻣﻮﺭﺩ ﺑﺮﺭﺳﻲ ﻗﺮﺍﺭ ﮔﺮﻓﺖ‪ .‬ﻫﻤﺎﻥ ﻃﻮﺭ ﻛﻪ ﺩﺭ ﺟﺪﻭﻝ‬
‫ﻣﺸﺎﻫﺪﻩ ﻣﻲﮔﺮﺩﺩ ﺑﻴﻦ ﺳﻄﺢ ﻛﻠﺴﺘﺮﻭﻝ ﺧﻮﻥ ﺍﻓﺮﺍﺩ ﻭ ﻣﻴﺰﺍﻥ ﺍﻓﺴﺮﺩﮔﻲﺷﺎﻥ‬
‫ﻫﻤﺒﺴﺘﮕﻲ ﻣﻨﻔﻲ ﻣﻌﻨﺎﺩﺍﺭﻱ )‪ (P<0/01 ،0/17‬ﻭﺟﻮﺩ ﺩﺍﺷﺖ‪ .‬ﻫﻢﭼﻨﻴﻦ‬
‫ﻣﻴﺎﻥ ﺳﻄﺢ ﻟﻴﭙﻮﭘﺮﻭﺗﺌﻴﻦﻫﺎ ﺑﺎ ﭼﮕﺎﻟﻲ ﺯﻳﺎﺩ ﺍﻓﺮﺍﺩ ﻭ ﻣﻴﺰﺍﻥ ﺍﻓﺴﺮﺩﮔﻲﺷﺎﻥ‬
‫ﻫﻤﺒﺴﺘﮕﻲ ﻣﻨﻔﻲ ﻣﻌﻨﺎﺩﺍﺭﻱ ﻣﺸﺎﻫﺪﻩ ﮔﺮﺩﻳﺪ‪.‬‬
‫ﻣﺤﺎﺳﺒﻪ ﺿﺮﻳﺐ ﻫﻤﺒﺴﺘﮕﻲ ﺟﺰﺋﻲ ﺑﻴﻦ ﻫﺮ ﻳﻚ ﺍﺯ ﻣﺘﻐﻴﺮﻫﺎ ﻭ ﻣﻴﺰﺍﻥ‬
‫ﺍﻓﺴﺮﺩﮔﻲ ﻧﺸﺎﻥ ﺩﻫﻨﺪﻩ ﺭﺍﺑﻄﻪ ﻣﻨﻔﻲ ﻭ ﻣﻌﻨﺎﺩﺍﺭ ﻣﻴﺎﻥ ﺳﻄﻮﺡ ﻛﻠﺴﺘﺮﻭﻝ ﻭ‬
‫‪ HDL‬ﺧﻮﻥ ﺑﺎ ﻣﻴﺰﺍﻥ ﺍﻓﺴﺮﺩﮔﻲ ﺑﻮﺩﻧﺪ‪ .‬ﺍﻳﻦ ﺩﺭﺣﺎﻟﻴﻴﺴﺖ ﻛﻪ ﻳﺎﻓﺘﻪﻫﺎﻱ‬
‫ﺑﺪﺳﺖ ﺁﻣﺪﻩ ﺭﺍﺑﻄﻪ ﻣﻌﻨﺎﺩﺍﺭﻱ ﺭﺍ ﻣﻴﺎﻥ ﺳﻄﻮﺡ ﺗﺮﻱﮔﻠﻴﺴﻴﺮﻳﺪ‪ ،‬ﻭ ‪ LDL‬ﺑﺎ‬
‫ﻣﻴﺰﺍﻥ ﺍﻓﺴﺮﺩﮔﻲ ﻧﺸﺎﻥ ﻧﻤﻲﺩﺍﺩ‪.‬‬
‫ﺑﻪ ﻣﻨﻈﻮﺭ ﺑﺮﺭﺳﻲ ﺭﺍﺑﻄﻪ ﻣﻴﺎﻥ ﺳﻄﻮﺡ ﻛﻠﺴﺘﺮﻭﻝ ﺧﻮﻥ ﺑﺎ ﻣﻴﺰﺍﻥ ﺍﻓﺴﺮﺩﮔﻲ‬
‫ﻋﻼﻭﻩ ﺑﺮ ﺿﺮﻳﺐ ﻫﻤﺒﺴﺘﮕﻲ‪ ،‬ﺭﮔﺮﺳﻴﻮﻥ ﺳﻠﺴﻠﻪ ﻣﺮﺍﺗﺒﻲ ﻧﻴﺰ ﺍﺟﺮﺍ ﮔﺮﺩﻳﺪ‪،‬‬
‫ﻛﻪ ﺩﺭ ﻧﺨﺴﺘﻴﻦ ﮔﺎﻡ ﺳﻦ ﻭ ﺩﺭ ﮔﺎﻡﻫﺎﻱ ﺩﻭﻡ ﻭ ﺳﻮﻡ ﺑﻪ ﺗﺮﺗﻴﺐ‪ ،‬ﺳﻄﻮﺡ‬
‫ﺗﺮﻱﮔﻠﻴﺴﻴﺮﻳﺪ ﻭ ﻟﻴﭙﻮﭘﺮﻭﺗﺌﻴﻦﻫﺎﻱ ﺧﻮﻥ ﻭﺍﺭﺩ ﻣﻌﺎﺩﻟﻪ ﺭﮔﺮﺳﻴﻮﻥ ﮔﺮﺩﻳﺪﻩ ﻭ‬
 ‫ﺑﺮﺭﺳﻰ ﺭﺍﺑﻄﻪ ﺳﻄﻮﺡ ﭼﺮﺑﻲﻫﺎ ﻭ ﻟﻴﭙﻮﭘﺮﻭﺗﺌﻲﻫﺎﻱ ﺧﻮﻥ ﺑﺎ ﺍﻓﺴﺮﺩﮔﻲ‬

‫ﺟﺪﻭﻝ ‪ -5‬ﺭﮔﺮﺳﻴﻮﻥ ﺳﻠﺴﻠﻪ ﻣﺮﺍﺗﺒﻰ ﻣﻴﺰﺍﻥ ﺍﻓﺴﺮﺩﮔﻰ ﺍﺯ ﺭﻭﻯ ﺳﻄﻮﺡ ﻛﻠﺴﺘﺮﻭﻝ ﺧﻮﻥ ﻓﺮﺍﺗﺮ ﺍﺯ ﺳﻦ‪ ،‬ﺳﻄﻮﺡ ﺗﺮﻯﮔﻠﻴﺴﻴﺮﻳﺪ ﻭ‬
‫ﻟﻴﭙﻮﭘﺮﻭﺗﺌﻴﻦﻫﺎ ﺑﺎ ﭼﮕﺎﻟﻰ ﻛﻢ )‪ (LDL‬ﻭ ﺯﻳﺎﺩ )‪(HDL‬‬

‫‪β‬‬ ‫∆‪F‬‬ ‫∆‪R‬‬ ‫‪R‬‬ ‫‪fd‬‬ ‫ﻣﺘﻐﻴﺮﻫﺎ‬ ‫ﻣﻴﺰﺍﻥ ﺍﻓﺴﺮﺩﮔﻲ‬

‫‪-0/277‬‬ ‫‪15/731‬‬ ‫‪-‬‬ ‫‪0/076‬‬ ‫‪191‬ﻭ‪1‬‬ ‫ﮔﺎﻡ ﺍﻭﻝ ﺳﻦ‬

‫‪0/044‬‬ ‫‪0/178‬‬ ‫‪0/001‬‬ ‫‪0/077‬‬ ‫‪190‬ﻭ‪1‬‬ ‫ﮔﺎﻡ ﺩﻭﻡ ﺗﺮﻯﮔﻠﻴﺴﻴﺮﻳﺪ‬

‫‪-0/315‬‬ ‫‪7/452‬‬ ‫‪0/068‬‬ ‫‪0/145‬‬ ‫‪188‬ﻭ‪2‬‬ ‫ﮔﺎﻡ ﺳﻮﻡ ﻟﻴﭙﻮﭘﺮﻭﺗﺌﻴﻦﻫﺎ ﺑﺎ ﭼﮕﺎﻟﻲ ﺯﻳﺎﺩ‬

‫‪0/083‬‬ ‫ﻭ ﻟﻴﭙﻮﭘﺮﻭﺗﺌﻴﻦﻫﺎ ﺑﺎ ﭼﮕﺎﻟﻰ ﻛﻢ‬

‫‪-0/212‬‬ ‫‪8/767‬‬ ‫‪0/038‬‬ ‫‪0/183‬‬ ‫‪187‬ﻭ‪1‬‬ ‫ﮔﺎﻡ ﭼﻬﺎﺭﻡ ﻛﻠﺴﺘﺮﻭﻝ‬

‫ﻧﺘﻴﺠﻪ ﻣﺤﺎﺳﺒﻪ ﺿﺮﻳﺐ ﻫﻤﺒﺴﺘﮕﻰ ﭘﻴﺮﺳﻮﻥ ﻣﻴﺎﻥ ﺩﻭ ﻣﺘﻐﻴﺮ ﻣﻴﺰﺍﻥ‬
‫ﺍﻓﺴﺮﺩﮔﻰ ﻭ ﺳﻄﺢ ﻛﻠﺴﺘﺮﻭﻝ ﺧﻮﻥ ﺩﺭ ﺍﻳﻦ ﭘﮋﻭﻫﺶ ﻣﻄﺎﺑﻖ ﺟﺪﻭﻝ ﺷﻤﺎﺭﻩ‬
‫‪ 2‬ﺑﺮﺍﺑﺮ ﺑﺎ ‪ -0/178‬ﻣﻲﺑﺎﺷﺪ ﻭ ﺩﺭ ﺳﻄﺢ ‪ P<0/001‬ﻣﻌﻨﺎﺩﺍﺭ ﺍﺳﺖ‪ .‬ﻧﺘﻴﺠﻪ‬
‫ﺑﺪﺳﺖ ﺁﻣﺪﻩ ﻓﺮﺿﻴﻪ ﻧﺨﺴﺖ ﺍﻳﻦ ﭘﮋﻭﻫﺶ ﻣﺒﻨﻰ ﺑﺮ ﻭﺟﻮﺩ ﺭﺍﺑﻄﻪ ﻣﻴﺎﻥ ﻣﻴﺰﺍﻥ‬
‫ﺍﻓﺴﺮﺩﮔﻰ ﻭ ﺳﻄﻮﺡ ﻛﻠﺴﺘﺮﻭﻝ ﺧﻮﻥ ﺭﺍ ﻣﻮﺭﺩ ﺗﺎﻳﻴﺪ ﻗﺮﺍﺭ ﻣﻰﺩﻫﺪ‪ .‬ﺟﺪﻭﻝ‬
‫ﺷﻤﺎﺭﻩ ‪ 5‬ﻧﺘﺎﻳﺞ ﺣﺎﺻﻞ ﺍﺯ ﺗﺤﻠﻴﻞ ﺭﮔﺮﺳﻴﻮﻥ ﺳﻠﺴﻠﻪ ﻣﺮﺍﺗﺒﻰ ﻣﻴﺰﺍﻥ ﺍﻓﺴﺮﺩﮔﻰ‬
‫ﺍﺯ ﺭﻭﻯ ﺳﻄﻮﺡ ﻛﻠﺴﺘﺮﻭﻝ ﺧﻮﻥ ﻓﺮﺍﺗﺮ ﺍﺯ ﺳﻦ‪ ،‬ﺳﻄﻮﺡ ﺗﺮﻯﮔﻠﻴﺴﻴﺮﻳﺪ ﻭ‬
‫ﻟﻴﭙﻮﭘﺮﻭﺗﺌﻴﻦﻫﺎﻯ ﺧﻮﻥ ﺭﺍ ﻧﺸﺎﻥ ﻣﻰﺩﻫﺪ‪.‬‬
‫ﻫﻤﺎﻥ ﻃﻮﺭ ﻛﻪ ﺩﺭ ﺟﺪﻭﻝ ﺷﻤﺎﺭﻩ ‪ 5‬ﻣﺸﺎﻫﺪﻩ ﻣﻲﮔﺮﺩﺩ ﻣﺘﻐﻴﺮ ﺳﻦ ﺭﺍﺑﻄﻪ‬
‫ﻣﻨﻔﻲ ﻭ ﻣﻌﻨﺎﺩﺍﺭﻱ ﺑﺎ ﻣﻴﺰﺍﻥ ﺍﻓﺴﺮﺩﮔﻲ ﺩﺍﺭﺩ‪ ،‬ﺩﺭ ﺳﻄﺢ ‪ P<0/001‬ﻭ‬
‫‪191)=15/73‬ﻭ‪ ،F(1‬ﻭ ﺑﻪ ﺗﻨﻬﺎﻳﻲ ‪ 6/7‬ﺩﺭﺻﺪ ﻣﻴﺰﺍﻥ ﺗﻐﻴﻴﺮﺍﺕ ﺍﻓﺴﺮﺩﮔﻲ ﺭﺍ‬
‫ﺗﺒﻴﻴﻦ ﻣﻲﻛﻨﺪ‪ .‬ﺳﻄﻮﺡ ﻛﻠﺴﺘﺮﻭﻝ ﺧﻮﻥ ﺑﺎ ﺑﺘﺎﻱ ‪ -0/212‬ﻭ ﺑﺎ ‪P<0/001‬‬
‫ﺭﺍﺑﻄﻪ ﻣﻌﻨﺎﺩﺍﺭ ﻭ ﻧﺴﺒﺘﺎ ﺑﺎﻻﻳﻲ ﺑﺎ ﻣﻴﺰﺍﻥ ﺍﻓﺴﺮﺩﮔﻲ ﺩﺍﺭﺩ‪ R∆ .‬ﻣﺤﺎﺳﺒﻪ‬
‫ﺷﺪﻩ ﻧﺸﺎﻥ ﻣﻲﺩﻫﺪ ﻛﻪ ﺳﻄﺢ ﻛﻠﺴﺘﺮﻭﻝ ﺧﻮﻥ ﺑﻪ ﺗﻨﻬﺎﻳﻲ ﻭ ﻓﺮﺍﺗﺮ ﺍﺯ ﺳﻦ‪،‬‬
‫ﺳﻄﻮﺡ ﺗﺮﻱﮔﻠﻴﺴﻴﺮﻳﺪ‪ ،‬ﻟﻴﭙﻮﭘﺮﻭﺗﺌﻴﻦﻫﺎ ﺑﺎ ﭼﮕﺎﻟﻲ ﻛﻢ ﻭ ﺯﻳﺎﺩ ‪ 3/8‬ﺩﺭﺻﺪ‬
‫ﺗﻐﻴﻴﺮﺍﺕ ﻣﻴﺰﺍﻥ ﺍﻓﺴﺮﺩﮔﻲ ﺭﺍ ﭘﻴﺶﺑﻴﻨﻲ ﻣﻲ ﻛﻨﺪ ‪ F(1,187) =8/767‬ﻭ‬
‫ﺗﺮﻯﮔﻠﻴﺴﻴﺮﻳﺪ ﺧﻮﻥ ﻭ ﻟﻴﭙﻮﭘﺮﻭﺗﺌﻴﻦ ﺑﺎ ﭼﮕﺎﻟﻰ ﻛﻢ )‪ (LDL‬ﺗﻮﺍﻥ ﭘﻴﺶﺑﻴﻨﻰ‬
‫ﻣﻴﺰﺍﻥ ﺍﻓﺴﺮﺩﮔﻰ ﺩﺭ ﺗﺤﻠﻴﻞ ﺭﮔﺮﺳﻴﻮﻥ ﻫﻤﺰﻣﺎﻥ ﺭﺍ ﻧﺪﺍﺷﺘﻨﺪ‪.‬‬
‫ﺑﻪ ﻣﻨﻈﻮﺭ ﭘﻴﺶﺑﻴﻨﻰ ﻣﻴﺰﺍﻥ ﺍﻓﺴﺮﺩﮔﻰ ﺍﺯ ﺭﻭﻯ ﻣﺘﻐﻴﺮﻫﺎﻯ ﺳﻄﻮﺡ‬
‫ﻛﻠﺴﺘﺮﻭﻝ‪ ،‬ﺗﺮﻯﮔﻠﻴﺴﻴﺮﻳﺪ‪ ،‬ﻟﻴﭙﻮﭘﺮﻭﺗﺌﻴﻦﻫﺎ ﺑﺎ ﭼﮕﺎﻟﻰ ﻛﻢ )‪ (LDL‬ﻭ ﺯﻳﺎﺩ‬
‫)‪ (HDL‬ﻓﺮﺍﺗﺮ ﺍﺯ ﻣﺘﻐﻴﺮ ﺳﻦ‪ ،‬ﺭﮔﺮﺳﻴﻮﻥ ﺳﻠﺴﻠﻪ ﻣﺮﺍﺗﺒﻰ ﺍﻧﺠﺎﻡ ﺷﺪ ﻛﻪ‬
‫ﺩﺭ ﺟﺪﻭﻝ ﺷﻤﺎﺭﻩ ‪ 4‬ﻧﺸﺎﻥ ﺩﺍﺩﻩ ﺷﺪﻩ ﺍﺳﺖ‪ .‬ﺩﺭ ﺭﮔﺮﺳﻴﻮﻥ ﺳﻠﺴﻠﻪ ﻣﺮﺍﺗﺒﻰ‬
‫ﻣﻄﺎﺑﻖ ﺟﺪﻭﻝ ﺷﻤﺎﺭﻩ ‪ ،4‬ﺩﺭ ﮔﺎﻡ ﺍﻭﻝ ﻣﺘﻐﻴﺮ ﺳﻦ ﻭ ﺩﺭ ﮔﺎﻡ ﺩﻭﻡ ﻣﺘﻐﻴﺮﻫﺎﻯ‬
‫ﺳﻄﻮﺡ ﻛﻠﺴﺘﺮﻭﻝ‪ ،‬ﺗﺮﻯﮔﻠﻴﺴﻴﺮﻳﺪ ﻭ ﻟﻴﭙﻮﭘﺮﻭﺗﺌﻴﻦﻫﺎ ﺑﺎ ﭼﮕﺎﻟﻰ ﻛﻢ ﻭ ﺯﻳﺎﺩ ﻭﺍﺭﺩ‬ ‫‪28‬‬
‫ﻣﺤﺎﺳﺒﻪ ﺷﺪﻩﺍﻧﺪ‪.‬‬
‫ﺑﺮﺍﺳﺎﺱ ﻧﺘﺎﻳﺞ ﺑﺪﺳﺖ ﺁﻣﺪﻩ ﻣﺘﻐﻴﻴﺮﻫﺎﻯ ﺳﻄﻮﺡ ﻛﻠﺴﺘﺮﻭﻝ‪ ،‬ﺗﺮﻯﮔﻠﻴﺴﻴﺮﻳﺪ‬
‫ﻭ ﻟﻴﭙﻮﭘﺮﻭﺗﺌﻴﻦﻫﺎﻯ ﺧﻮﻥ ﻓﺮﺍﺗﺮ ﺍﺯ ﻣﺘﻐﻴﺮ ﺳﻦ ﺑﻪ ﻃﻮﺭ ﻣﻌﻨﺎﺩﺍﺭﻯ ﻣﻴﺰﺍﻥ‬
‫ﺍﻓﺴﺮﺩﮔﻰ ﺭﺍ ﭘﻴﺶﺑﻴﻨﻰ ﻣﻰﻧﻤﺎﻳﻨﺪ‪ .‬ﺑﻪ ﻋﺒﺎﺭﺕ ﺩﻳﮕﺮﺑﺮﺍﺳﺎﺱ ‪ ∆R‬ﻣﺤﺎﺳﺒﻪ‬
‫ﺷﺪﻩ ﻣﺠﻤﻮﻋﻪ ﻣﺘﻌﻴﺮﻫﺎﻱ ﺳﻄﻮﺡ ﻛﻠﺴﺘﺮﻭﻝ‪ ،‬ﺗﺮﻱﮔﻠﻴﺴﻴﺮﻳﺪ‪ ،‬ﻟﻴﭙﻮﭘﺮﻭﺗﺌﻴﻦ ﺑﺎ‬
‫ﭼﮕﺎﻟﻲ ﻛﻢ ﻭ ﺯﻳﺎﺩ ‪ 10/7‬ﺩﺭﺻﺪ ﺗﻐﻴﻴﺮﺍﺕ ﻣﻴﺰﺍﻥ ﺍﻓﺴﺮﺩﮔﻲ ﺭﺍ ﻓﺮﺍﺗﺮ ﺍﺯ ﻣﺘﻐﻴﺮ‬
‫ﺳﻦ ﭘﻴﺶﺑﻴﻨﻲ ﻣﻲﻧﻤﺎﻳﻨﺪ ﻛﻪ ﺑﺎ ‪ F(4,187)=6/21‬ﺩﺭ ﺳﻄﺢ ‪P<0/001‬‬
‫ﻣﻌﻨﺎﺩﺍﺭ ﻣﻰﺑﺎﺷﺪ‪.‬‬

‫ﺟﺪﻭﻝ ‪ -6‬ﺭﮔﺮﺳﻴﻮﻥ ﺳﻠﺴﻠﻪ ﻣﺮﺍﺗﺒﻰ ﻣﻴﺰﺍﻥ ﺍﻓﺴﺮﺩﮔﻰ ﺍﺯ ﺭﻭﻯ ﺳﻄﻮﺡ ﺗﺮﻯﮔﻠﻴﺴﻴﺮﻳﺪ ﺧﻮﻥ‬
‫ﻓﺮﺍﺗﺮ ﺍﺯ ﺳﻄﻮﺡ ﻛﻠﺴﺘﺮﻭﻝ ﻭ ﻟﻴﭙﻮﭘﺮﻭﺗﺌﻴﻦﻫﺎ ﺑﺎ ﭼﮕﺎﻟﻰ ﻛﻢ ﻭ ﺯﻳﺎﺩ ﺧﻮﻥ‬

‫‪β‬‬ ‫∆‪F‬‬ ‫∆‪R‬‬ ‫‪R‬‬ ‫‪fd‬‬ ‫ﻣﺘﻐﻴﺮﻫﺎ‬ ‫ﻣﻴﺰﺍﻥ ﺍﻓﺴﺮﺩﮔﻲ‬

‫‪-0/277‬‬ ‫‪15/731‬‬ ‫‪-‬‬ ‫‪0/076‬‬ ‫‪191‬ﻭ‪1‬‬ ‫ﮔﺎﻡ ﺍﻭﻝ ﺳﻦ‬

‫‪-0/212‬‬ ‫‪3/138‬‬ ‫‪0/015‬‬ ‫‪0/091‬‬ ‫‪190‬ﻭ‪1‬‬ ‫ﮔﺎﻡ ﺩﻭﻡ ﻛﻠﺴﺘﺮﻭﻝ‬

‫‪-0/315‬‬ ‫‪10/374‬‬ ‫‪0/09‬‬ ‫‪0/181‬‬ ‫‪188‬ﻭ‪2‬‬ ‫ﮔﺎﻡ ﺳﻮﻡ ﻟﻴﭙﻮﭘﺮﻭﺗﺌﻴﻦ ﻫﺎ ﺑﺎ ﭼﮕﺎﻟﻲ ﺯﻳﺎﺩ‬

‫‪0/083‬‬ ‫ﻭ ﻟﻴﭙﻮﭘﺮﻭﺗﺌﻴﻦ ﻫﺎ ﺑﺎ ﭼﮕﺎﻟﻰ ﻛﻢ‬

‫‪0/044‬‬ ‫‪0/37‬‬ ‫‪0/002‬‬ ‫‪0/183‬‬ ‫‪187‬ﻭ‪1‬‬ ‫ﮔﺎﻡ ﭼﻬﺎﺭﻡ ﺗﺮﻯ ﮔﻠﻴﺴﻴﺮﻳﺪ‬

‫**‬ ‫***‬
‫‪p<0/001‬‬ ‫‪p <0/0001‬‬
 ‫ﻃﺒﺎﻃﺒﺎﺋﻲ ﻭ ﻫﻤﻜﺎﺭﺍﻥ‬
‫ﺟﺪﻭﻝ ‪ -7‬ﺭﮔﺮﺳﻴﻮﻥ ﺳﻠﺴﻠﻪ ﻣﺮﺍﺗﺒﻰ ﻣﻴﺰﺍﻥ ﺍﻓﺴﺮﺩﮔﻰ ﺍﺯ ﺭﻭﻯ ﻣﺘﻐﻴﺮﻫﺎﻯ ﺳﻄﻮﺡ ﻟﻴﭙﻮﭘﺮﻭﺗﺌﻴﻦﻫﺎﻯ ﺧﻮﻥ‬
‫ﻓﺮﺍﺗﺮ ﺍﺯ ﺳﻄﻮﺡ ﺗﺮﻯﮔﻠﻴﺴﻴﺮﻳﺪ ﻭ ﻛﻠﺴﺘﺮﻭﻝ ﺧﻮﻥ‬
‫‪β‬‬ ‫∆‪F‬‬ ‫∆‪R‬‬
‫‪-0/277‬‬ ‫‪15/731‬‬ ‫‪-‬‬
‫‪0/044‬‬ ‫‪0/0178‬‬ ‫‪0/001‬‬
‫‪-0/212‬‬ ‫‪3/742‬‬ ‫‪0/018‬‬
‫‪-0/315‬‬ ‫‪10/092‬‬ ‫‪0/088‬‬
‫‪0/083‬‬
‫**‬ ‫***‬
‫‪p<0/001‬‬ ‫‪p <0/0001‬‬
‫ﺑﺎ ﭼﮕﺎﻟﻲ ﺯﻳﺎﺩ ﻭ ﻟﻴﭙﻮﭘﺮﻭﺗﺌﻴﻦﻫﺎ ﺑﺎ ﭼﮕﺎﻟﻲ ﻛﻢ ﻫﻢﭼﻨﺎﻥ ﻣﻌﻨﺎﺩﺍﺭ ﺑﻮﺩ‪ .‬ﺩﺭ ﻭﺍﻗﻊ‬
‫ﻧﺘﺎﻳﺞ ﺑﺪﺳﺖ ﺁﻣﺪﻩ ﻫﻤﮕﺎﻡ ﺑﺎ ﻧﺘﺎﻳﺞ ﺗﺤﻘﻴﻘﺎﺗﻲ ﺍﺳﺖ ﻛﻪ ﺭﺍﺑﻄﻪ ﻣﻴﺎﻥ ﺳﻄﻮﺡ‬
‫ﻛﻠﺴﺘﺮﻭﻝ ﺧﻮﻥ ﻭ ﻣﻴﺰﺍﻥ ﺍﻓﺴﺮﺩﮔﻲ ﺭﺍ ﻣﻮﺭﺩ ﺗﺎﻳﻴﺪ ﻗﺮﺍﺭ ﺩﺍﺩﻩﺍﻧﺪ‪ .‬ﺑﺪﻳﻦ ﻣﻌﻨﻰ‬
‫ﻛﻪ ﺍﻓﺮﺍﺩﻯ ﺑﺎ ﺳﻄﻮﺡ ﻛﻠﺴﺘﺮﻭﻝ ﺧﻮﻥ ﻛﻤﺘﺮ ﺍﺣﺘﻤﺎﻻ ﺍﺯ ﻣﻴﺰﺍﻥ ﺍﻓﺴﺮﺩﮔﻰ‬
‫ﺑﻴﺸﺘﺮﻯ ﺭﻧﺞ ﻣﻰﺑﺮﻧﺪ‪ .‬ﺁﻧﭽﻪ ﺗﺤﻘﻴﻖ ﻛﻨﻮﻧﻲ ﺭﺍ ﺗﺎ ﺍﻧﺪﺍﺯﻩﺍﻱ ﺍﺯ ﺗﺤﻘﻴﻘﺎﺕ‬
‫ﻣﺸﺎﺑﻪ ﺍﻧﺠﺎﻡ ﺷﺪﻩ ﺩﺭ ﺍﻳﻦ ﻋﺮﺻﻪ ﻣﺘﻤﺎﻳﺰ ﻣﻲﺳﺎﺯﺩ‪ ،‬ﺩﺭ ﻧﻈﺮ ﮔﺮﻓﺘﻦ ﻫﻢ ﺯﻣﺎﻥ‬
‫‪29‬‬ ‫ﺍﺛﺮ ﻣﺘﻐﻴﺮﻫﺎﻱ ﻣﻮﺭﺩ ﺑﺮﺭﺳﻲ ﻭ ﺍﺳﺘﻔﺎﺩﻩ ﺍﺯ ﺗﺤﻠﻴﻞﻫﺎﻱ ﭘﻴﭽﻴﺪﻩﺗﺮ ﺁﻣﺎﺭﻱ‬
‫ﺟﻬﺖ ﺍﺧﺬ ﻧﺘﺎﻳﺞ ﺩﻗﻴﻖﺗﺮ ﻣﻲﺑﺎﺷﺪ‪.‬‬
‫ﺩﺭ ﺗﺒﻴﻴﻦ ﻧﺘﺎﻳﺞ ﻣﺸﺎﻫﺪﻩ ﺷﺪﻩ ﻣﻰﺗﻮﺍﻥ ﺑﻪ ﻧﻘﺶ ﻭ ﺍﻫﻤﻴﺖ ﻛﻠﺴﺘﺮﻭﻝ‬
‫ﺩﺭ ﺳﺎﺧﺘﺎﺭ ﻭ ﻛﻨﺶ ﺳﻴﺴﺘﻢ ﻋﺼﺒﻰ ﻣﺮﻛﺰﻯ ﺍﺷﺎﺭﻩ ﻧﻤﻮﺩ‪ .‬ﻫﻤﺎﻥ ﻃﻮﺭ ﻛﻪ‬
‫ﻣﻰﺩﺍﻧﻴﻢ ﺳﻴﺴﺘﻢ ﻋﺼﺒﻰ ﻣﺮﻛﺰﻯ ﺣﺎﻭﻯ ﻛﻠﺴﺘﺮﻭﻝ ﻓﺮﺍﻭﺍﻧﻰ ﺍﺳﺖ ﻛﻪ ﺑﺮﺍﻯ‬
‫ﺑﺴﻴﺎﺭﻯ ﺍﺯ ﺟﻨﺒﻪﻫﺎﻯ ﻛﻨﺸﻰ ﻭ ﺳﺎﺧﺘﺎﺭﻯ ﺳﻠﻮﻝ ﺣﺎﺋﺰ ﺍﻫﻤﻴﺖ ﻣﻰﺑﺎﺷﺪ‪ .‬ﺩﺭ‬
‫ﻭﺍﻗﻊ ﻛﻠﺴﺘﺮﻭﻝ ﺑﺮ ﺳﻴﺎﻟﻴﺖ‪ ،‬ﻧﻔﻮﺫﭘﺬﻳﺮﻯ ﻭ ﻓﺮﺍﻳﻨﺪ ﻣﺒﺎﺩﻟﻪ ﻏﺸﺎﻫﺎﻯ ﺳﻠﻮﻟﻰ‬
‫ﺗﺎﺛﻴﺮﮔﺬﺍﺭ ﺍﺳﺖ‪ .‬ﺑﺮﺧﻰ ﻣﺤﻘﻘﻴﻦ ﺍﻇﻬﺎﺭ ﺩﺍﺷﺘﻪﺍﻧﺪ ﻛﻪ ﭘﺎﻳﻴﻦ ﺑﻮﺩﻥ ﺳﻄﺢ‬
‫ﻛﻠﺴﺘﺮﻭﻝ ﺩﺭ ﺳﻴﺴﺘﻢ ﻋﺼﺒﻰ ﻣﺮﻛﺰﻯ‪ ،‬ﻭ ﺗﺎﺛﻴﺮ ﺍﺣﺘﻤﺎﻟﻰ ﺁﻥ ﺩﺭ ﻫﺮ ﺩﻭ ﺑﺨﺶ‬
‫ﭘﻴﺶ ﺳﻴﻨﺎﭘﺴﻰ ))ﺟﺎﻳﻰ ﻛﻪ ﻣﻮﺟﺐ ﺍﻓﺰﺍﻳﺶ ﺑﺎﺯﺟﺬﺏ ﺳﺮﻭﺗﻮﻧﻴﻦ ﻣﻰﮔﺮﺩﺩ( ﻭ‬
‫ﭘﺲ ﺳﻴﻨﺎﭘﺴﻰ )ﺟﺎﻳﻰ ﻛﻪ ﺗﻌﺪﺍﺩ ﻭ ﻛﻨﺶ ﮔﻴﺮﻧﺪﻩﻫﺎﻯ ‪ 1HT-5‬ﺭﺍ ﻛﺎﻫﺶ‬
‫ﻣﻰﺩﻫﺪ(‪ ،‬ﻣﻮﺟﺐ ﻛﺎﻫﺶ ﻓﻌﺎﻟﻴﺖ ﻃﺒﻴﻌﻰ ﺳﻴﺴﺘﻢ ﺳﺮﻭﺗﻮﻧﺮژﻳﻚ ﻣﻲﮔﺮﺩﺩ‪.‬‬
‫ﺷﻮﺍﻫﺪ ﻣﺮﺑﻮﻁ ﺑﻪ ﺗﺎﺛﻴﺮ ﭘﺎﻳﻴﻦ ﺑﻮﺩﻥ ﺳﻄﻮﺡ ﻛﻠﺴﺘﺮﻭﻝ ﺧﻮﻥ ﺑﺮ ﻛﺎﻫﺶ‬
‫ﻓﻌﺎﻟﻴﺖ ﺳﻴﺴﺘﻢ ﺳﺮﺗﻮﻧﺮژﻳﻚ ﺩﺭ ﺳﻴﺴﺘﻢ ﻋﺼﺒﻰ ﻣﺮﻛﺰﻯ ﺣﺎﺻﻞ ﻣﻄﺎﻟﻌﺎﺕ‬
‫ﻟﻴﭙﻮﭘﺮﻭﺗﺌﻴﻦ ﺑﺎ ﭼﮕﺎﻟﻰ ﺯﻳﺎﺩ ))‪ (HDL‬ﺑﺎ ﺍﻓﺰﺍﻳﺶ ﻣﻴﺰﺍﻥ ﺍﻓﺴﺮﺩﮔﻰ ﺩﺭ ﺍﻓﺮﺍﺩ‬
‫ﺁﺯﻣﺎﻳﺸﮕﺎﻫﻰ ﺍﻧﺠﺎﻡ ﺷﺪﻩ ﺑﺮ ﺭﻭﻯ ﻧﺨﺴﺘﻰﻫﺎﺳﺖ‪ .‬ﺍﻳﻦ ﻣﻄﺎﻟﻌﺎﺕ ﻧﺸﺎﻥ ﺩﺍﺩ‬
‫ﻛﻪ ﻣﻴﻤﻮﻥﻫﺎﻳﻰ ﻛﻪ ﺍﺯ ﺭژﻳﻢ ﻏﺬﺍﻳﻰ ﻛﻢ ﭼﺮﺑﻰ ﺍﺳﺘﻔﺎﺩﻩ ﻣﻰﻛﺮﺩﻧﺪ ﺩﺭ ﭘﺎﺳﺦ‬
‫ﺑﻪ ﻓﻦ ﻓﻠﻮﺭﺍﻣﻴﻦ‪ 2‬ﻛﻪ ﺁﮔﻮﻧﻴﺴﺖ ﺳﺮﻭﺗﻮﻧﻴﻦ )‪ (HT-5‬ﻣﻰﺑﺎﺷﺪ ﺍﺯ ﺍﻓﺖ‬
‫ﭘﺮﻭﻻﻛﺘﻴﻦ ﺑﺮﺧﻮﺭﺩﺍﺭ ﺑﻮﺩﻧﺪ ﻛﻪ ﺧﻮﺩ ﻧﺸﺎﻥ ﺩﻫﻨﺪﻩ ﻛﺎﻫﺶ ﻓﻌﺎﻟﻴﺖ ﺳﺮﻭﺗﻮﻧﻴﻦ‬
‫)‪ (HT-5‬ﻣﻰﺑﺎﺷﺪ‪ .‬ﻛﺎﭘﻼﻥ ﻭ ﻫﻤﻜﺎﺭﺍﻧﺶ )ﻛﺎﭘﻼﻥ‪ ،‬ﺷﻴﻮﻟﻰ‪ ،‬ﻓﻮﻧﺘﻨﻮﺕ‪،‬‬
‫ﻣﻮﺭﮔﺎﻥ‪ ،‬ﻫﺎﻭﻝ‪ ،‬ﻣﺎﻧﻮﻙ‪ ،‬ﻣﻮﻟﺪﻡ ﻭ ﻣﺎﻥ‪ (1994 ،‬ﺩﺭ ﺑﺨﺸﻰ ﺍﺯ ﺁﺯﻣﺎﻳﺸﺎﺕ‬
‫ﺧﻮﺩ ﺍﺯ ﻃﺮﻳﻖ ﺳﻨﺠﺶ ﻣﻮﺍﺩ ﺳﻮﺧﺖ ﻭ ﺳﺎﺯ ﺷﺪﻩ‪ 3‬ﻣﻮﻧﻮﺁﻣﻴﻦﻫﺎ ))ﻛﻪ ﺩﺭ ﻣﺎﻳﻊ‬
‫‪1- 5-hydroxy tryptamine‬‬
‫‪2- fenfluramine‬‬
‫‪3- metabolites‬‬
‫ﻣﻴﺰﺍﻥ ﺍﻓﺴﺮﺩﮔﻲ‬
‫‪R‬‬ ‫‪fd‬‬
‫ﻣﺘﻐﻴﺮﻫﺎ‬
‫‪0/076‬‬ ‫‪191‬ﻭ‪1‬‬ ‫ﮔﺎﻡ ﺍﻭﻝ ﺳﻦ‬
‫‪0/077‬‬ ‫‪190‬ﻭ‪1‬‬ ‫ﮔﺎﻡ ﺩﻭﻡ ﺗﺮﻯ ﮔﻠﻴﺴﻴﺮﻳﺪ‬
‫‪0/095‬‬ ‫‪189‬ﻭ‪1‬‬ ‫ﮔﺎﻡ ﺳﻮﻡ ﻛﻠﺴﺘﺮﻭﻝ‬
‫‪0/183‬‬ ‫‪187‬ﻭ‪2‬‬ ‫ﮔﺎﻡ ﭼﻬﺎﺭﻡ ﻟﻴﭙﻮﭘﺮﻭﺗﺌﻴﻦ ﻫﺎ ﺑﺎ ﭼﮕﺎﻟﻲ ﺯﻳﺎﺩ‬
‫ﻭ ﻟﻴﭙﻮﭘﺮﻭﺗﺌﻴﻦ ﻫﺎ ﺑﺎ ﭼﮕﺎﻟﻰ ﻛﻢ‬
‫)‪ .(P<0/001‬ﺍﻳﻦ ﺍﻣﺮ ﻧﺸﺎﻧﮕﺮ ﺁﻥ ﺍﺳﺖ ﻛﻪ ﻛﻪ ﻫﺮﭼﻪ ﺳﻄﺢ ﻛﻠﺴﺘﺮﻭﻝ‬
‫ﺧﻮﻥ ﭘﺎﻳﻴﻦﺗﺮ ﺑﺎﺷﺪ‪ ،‬ﻣﻴﺰﺍﻥ ﺍﻓﺴﺮﺩﮔﻲ ﺑﺎﻻﺗﺮ ﺍﺳﺖ‪.‬‬
‫ﺟﺪﻭﻝ ﺷﻤﺎﺭﻩ ‪ 6‬ﻧﺘﺎﻳﺞ ﺣﺎﺻﻞ ﺍﺯ ﺗﺤﻠﻴﻞ ﺭﮔﺮﺳﻴﻮﻥ ﺳﻠﺴﻠﻪ ﻣﺮﺍﺗﺒﻰ ﻣﻴﺰﺍﻥ‬
‫ﺍﻓﺴﺮﺩﮔﻰ ﺍﺯ ﺭﻭﻯ ﺳﻄﻮﺡ ﺗﺮﻯﮔﻠﻴﺴﻴﺮﻳﺪ ﺧﻮﻥ ﻓﺮﺍﺗﺮ ﺍﺯ ﺳﻄﻮﺡ ﻛﻠﺴﺘﺮﻭﻝ ﻭ‬
‫ﻟﻴﭙﻮﭘﺮﻭﺗﺌﻴﻦﻫﺎﻯ ﺧﻮﻥ ﺭﺍ ﻧﺸﺎﻥ ﻣﻰﺩﻫﺪ‪.‬‬
‫ﻫﻤﺎﻥ ﻃﻮﺭ ﻛﻪ ﺩﺭ ﺟﺪﻭﻝ ﺷﻤﺎﺭﻩ ‪ 6‬ﻧﺸﺎﻥ ﺩﺍﺩﻩ ﺷﺪﻩ ﺍﺳﺖ‪ .‬ﺑﻴﻦ ﻣﻴﺰﺍﻥ‬
‫ﺍﻓﺴﺮﺩﮔﻲ ﺷﺮﻛﺖ ﻛﻨﻨﺪﮔﺎﻥ ﺩﺭ ﺍﻳﻦ ﭘﮋﻭﻫﺶ ﻭ ﺳﻄﺢ ﺗﺮﻱﮔﻠﻴﺴﻴﺮﻳﺪ ﺧﻮﻥ‬
‫ﻓﺮﺍﺗﺮ ﺍﺯ ﺳﻦ‪ ،‬ﺳﻄﻮﺡ ﻛﻠﺴﺘﺮﻭﻝ‪ ،‬ﻟﻴﭙﻮﭘﺮﻭﺗﺌﻴﻦ ﺑﺎ ﭼﮕﺎﻟﻲ ﺯﻳﺎﺩ ﻭ ﻛﻢ ﺭﺍﺑﻄﻪ‬
‫ﺘﺎﻳﺞ ﺍﺟﺮﺍﻱ ﺭﮔﺮﺳﻴﻮﻥ ﺳﻠﺴﻠﻪ ﻣﺮﺍﺗﺒﻲ ﺩﺭ ﺭﺍﺑﻄﻪ‬‫ﻣﻌﻨﺎﺩﺍﺭﻱ ﻭﺟﻮﺩ ﻧﺪﺍﺭﺩ‪ .‬ﻧﺘﺎﻳﺞ‬
‫ﺑﺎ ﺳﻄﻮﺡ ﺗﺮﻱﮔﻠﻴﺴﻴﺮﻳﺪ ﻧﺘﺎﻳﺞ ﻣﻌﻨﺎﺩﺍﺭﻱ ﺭﺍ ﺩﺭ ﺭﺍﺑﻄﻪ ﺑﺎ ﻗﺪﺭﺕ ﭘﻴﺶﺑﻴﻨﻲ‬
‫ﻣﻴﺰﺍﻥ ﺍﻓﺴﺮﺩﮔﻲ ﺑﺮ ﺍﺳﺎﺱ ﺳﻄﻮﺡ ﺗﺮﻱﮔﻠﻴﺴﻴﺮﻳﺪ ﻓﺮﺍﺗﺮ ﺍﺯ ﻣﺘﻐﻴﺮﻫﺎﻱ ﺳﻄﻮﺡ‬
‫ﻛﻠﺴﺘﺮﻭﻝ‪ ،‬ﻭ ﻟﻴﭙﻮﭘﺮﻭﺗﺌﻴﻦﻫﺎﻱ ﺧﻮﻥ ﻧﺒﻮﺩ‪.‬‬
‫ﻫﻤﺎﻥ ﻃﻮﺭ ﻛﻪ ﺩﺭ ﺟﺪﻭﻝ ﺷﻤﺎﺭﻩ ‪ 7‬ﻧﻤﺎﻳﺎﻥ ﺍﺳﺖ‪ ،‬ﻣﻴﺰﺍﻥ ﻟﻴﭙﻮﭘﺮﻭﺗﺌﻴﻦ ﺑﺎ‬
‫ﭼﮕﺎﻟﻰ ﺯﻳﺎﺩ )‪ (HDL‬ﺑﺎ ﻣﻘﺪﺍﺭ ﺑﺘﺎﻱ )‪ (-0/315‬ﻭ ﺑﺎ ‪ P<0/0001‬ﺭﺍﺑﻄﻪ‬
‫ﻣﻌﻨﺎﺩﺍﺭ ﻭ ﺑﺎﻻﻳﻰ ﺑﺎ ﻣﻴﺰﺍﻥ ﺍﻓﺴﺮﺩﮔﻰ ﺩﺍﺭﺩ‪ R∆.‬ﻣﺤﺎﺳﺒﻪ ﺷﺪﻩ ﺩﺭ ﺟﺪﻭﻝ‬
‫ﻧﺸﺎﻥ ﻣﻰﺩﻫﺪ ﻛﻪ ﺳﻄﻮﺡ ﻟﻴﭙﻮﭘﺮﻭﺗﺌﻴﻦﻫﺎ ﺑﻪ ﺗﻨﻬﺎﻳﻰ ‪ 8/8‬ﺩﺭﺻﺪ ﺍﺯ ﺗﻐﻴﻴﺮﺍﺕ‬
‫ﻣﻴﺰﺍﻥ ﺍﻓﺴﺮﺩﮔﻰ ﺭﺍ ﻓﺮﺍﺗﺮ ﺍﺯ ﺳﻄﻮﺡ ﻛﻠﺴﺘﺮﻭﻝ ﻭ ﺗﺮﻯﮔﻠﻴﺴﻴﺮﻳﺪ ﺧﻮﻥ‬
‫ﭘﻴﺶﺑﻴﻨﻰ ﻣﻰﻧﻤﺎﻳﻨﺪ ﻛﻪ ﺑﺎ ‪ F (2/187) =10/092‬ﺩﺭ ﺳﻄﺢ ‪P<0/0001‬‬
‫ﻣﻌﻨﺎﺩﺍﺭ ﻣﻰﺑﺎﺷﺪ‪ .‬ﻧﺘﺎﻳﺞ ﺑﺪﺳﺖ ﺁﻣﺪﻩ ﻧﺸﺎﻧﮕﺮ ﺁﻧﺴﺖ ﻛﻪ ﭘﺎﻳﻴﻦ ﺁﻣﺪﻥ ﺳﻄﻮﺡ‬
‫ﺍﻓﺮﺍﺩ‪،‬‬
‫ﺭﺍﺑﻄﻪ ﺩﺍﺭﺩ‪.‬‬
‫ﺑﺤﺚ ﻭ ﺗﻔﺴﻴﺮ‬
‫ﻫﻤﺎﻥ ﻃﻮﺭ ﻛﻪ ﻣﺸﺎﻫﺪﻩ ﮔﺮﺩﻳﺪ ﺩﺭ ﺍﻳﻦ ﭘﮋﻭﻫﺶ ﺑﻴﻦ ﺳﻄﻮﺡ ﻛﻠﺴﺘﺮﻭﻝ ﺧﻮﻥ‬
‫ﺍﻓﺮﺍﺩ ﻭ ﻣﻴﺰﺍﻥ ﺍﻓﺴﺮﺩﮔﻲ ﺷﺎﻥ ﻫﻤﺒﺴﺘﮕﻲ ﻣﻨﻔﻲ ﻭ ﻣﻌﻨﺎﺩﺍﺭﻱ ﻭﺟﻮﺩ ﺩﺍﺷﺖ‪.‬‬
‫ﺗﺤﻠﻴﻞ ﻧﺘﺎﻳﺞ ﺍﺟﺮﺍﻯ ﺭﮔﺮﺳﻴﻮﻥ ﺳﻠﺴﻠﻪ ﻣﺮﺍﺗﺒﻰ ﻧﺸﺎﻥ ﺩﺍﺩ ﻛﻪ ﺍﻳﻦ ﺭﺍﺑﻄﻪ‬
‫ﺣﺘﻲ ﭘﺲ ﺍﺯ ﻛﻨﺘﺮﻝ ﻣﺘﻐﻴﻴﺮﻫﺎﻱ ﺳﻦ‪ ،‬ﺳﻄﻮﺡ ﺗﺮﻱﮔﻠﻴﺴﻴﺮﻳﺪ‪ ،‬ﻟﻴﭙﻮﭘﺮﻭﺗﺌﻴﻦﻫﺎ‬

‫ﻛﻠﺴﺘﺮﻭﻝ ﻣﻰﺗﻮﺍﻧﺪ ﺍﻧﺘﻘﺎﻝ ﻣﻌﻜﻮﺱ ﻛﻠﺴﺘﺮﻭﻝ ﺍﺯ ﺳﻤﺖ ﺑﺎﻓﺖﻫﺎ ﺑﻪ ﻛﺒﺪ ﺭﺍ‬
‫ﺗﺤﺖ ﺗﺎﺛﻴﺮ ﻗﺮﺍﺭ ﺩﻫﺪ ﻭ ﻧﻬﺎﻳﺘ ًﺎ ﻣﻨﺠﺮ ﺑﻪ ﺗﻐﻴﻴﺮ ﺩﺭ ﺗﺮﻛﻴﺐ ﭼﺮﺑﻰﻫﺎﻯ ﺧﻮﻥ‪،‬‬
‫ﺷﻮﺩ‪.‬‬
‫ﻧﻈﻴﺮ ﻣﻴﺰﺍﻥ ﺗﻮﻟﻴﺪ ﻟﻴﭙﻮﭘﺮﻭﺗﺌﻴﻦﻫﺎ ﺑﺎ ﭼﮕﺎﻟﻲ ﺯﻳﺎﺩ )‪ (HDL‬ﺷﻮﺩ‬
‫ﭼﻨﻴﻦ ﺗﻐﻴﻴﺮﺍﺗﻰ ﺩﺭ ﻧﺴﺒﺖ ﻣﻮﻟﻔﻪﻫﺎﻯ ﻣﺨﺘﻠﻒ ﭼﺮﺑﻰﻫﺎﻯ ﺧﻮﻥ ﻣﻰﺗﻮﺍﻧﺪ‬
‫ﻣﻮﺟﺐ ﺗﻐﻴﻴﺮ ﺩﺭ ﻣﻴﻜﺮﻭﻭﻳﺴﻜﻮﺯﻳﺘﻪ‪ 6‬ﻏﺸﺎﻫﺎﻯ ﺳﻠﻮﻟﻰ ﮔﺸﺘﻪ ﻭ ﻧﻬﺎﻳﺘ ًﺎ ﺑﺮ‬
‫ﺗﻌﺪﺍﺩﻯ ﺍﺯ ﺁﻣﻴﻦﻫﺎﻯ ﺑﻴﻮژﻧﻴﻚ ﻭ ﻛﻨﺶﻫﺎﻯ ﻣﺮﺗﺒﻂ ﺑﺎ ﺁﻧﻬﺎ‪ ،‬ﻧﻈﻴﺮ ﺟﺬﺏ‬
‫ﺳﺮﻭﺗﻮﻧﻴﻦ‪ ،‬ﻓﻌﺎﻟﻴﺖ ﻣﻮﻧﻮﺁﻣﻴﻦ ﺍﻛﺴﻴﺪﺍﺯ ﻭ ﻏﻠﻈﺖﻫﺎﻯ ﻛﺎﺗﻜﻮﻝ ﺁﻣﻴﻦﻫﺎ ﻭ‬
‫ﺳﺮﻭﺗﻮﻧﻴﻦ ﺩﺭ ﻣﻐﺰ ﺗﺎﺛﻴﺮ ﺑﮕﺬﺍﺭﺩ‪ .‬ﺑﺪﻳﻦ ﺗﺮﺗﻴﺐ ﺗﻐﻴﻴﺮ ﺩﺭ ﭼﺮﺑﻰﻫﺎﻯ ﺧﻮﻥ‬
‫ﻣﻰﺗﻮﺍﻧﺪ ﺩﺭ ﺟﻨﺒﻪ ﻣﻮﻧﻮﺁﻣﻴﻨﺮژﻳﻚ‪ 7‬ﺗﺒﻴﻴﻦ ﺍﻓﺴﺮﺩﮔﻰ ﻧﻘﺶ ﺩﺍﺷﺘﻪ ﺑﺎﺷﻨﺪ‪.‬‬
‫ﺩﺭ ﺍﻳﻨﺠﺎ ﻫﻢ ﻻﺯﻡ ﺑﻪ ﺫﻛﺮ ﺍﺳﺖ ﻛﻪ ﻋﻮﺍﻣﻞ ﺗﻐﺬﻳﻪﺍﻯ ﻣﺮﺗﺒﻂ ﺑﺎ ﺧﻠﻖ ﻧﻴﺰ‬
‫ﻣﻤﻜﻦ ﺍﺳﺖ ﺗﺒﻴﻴﻦ ﻛﻨﻨﺪﻩ ﺭﺍﺑﻄﻪ ﻣﻴﺎﻥ ﻛﻠﺴﺘﺮﻭﻝ ﻭ ﺍﻓﺴﺮﺩﮔﻰ ﺑﺎﺷﻨﺪ ﺑﺎ ﺍﻳﻦ‬
‫ﻭﺟﻮﺩ ﺗﺤﻘﻴﻘﺎﺕ ﺗﺎ ﻛﻨﻮﻥ ﺍﻳﻦ ﺭﺍﺑﻄﻪ ﺭﺍ ﺑﻪ ﺻﻮﺭﺕ ﺩﻗﻴﻖ ﻣﻮﺭﺩ ﺗﺎﻳﻴﺪ ﻗﺮﺍﺭ‬
‫ﻧﺪﺍﺩﻩﺍﻧﺪ‪ .‬ﺍﺯ ﻃﺮﻑ ﺩﻳﮕﺮ ﻣﻄﺎﻟﻌﺎﺗﻰ ﻧﻈﻴﺮ ﺁﺯﻣﺎﻳﺸﺎﺕ ﺍﻧﺠﺎﻡ ﺷﺪﻩ ﺗﻮﺳﻂ ﻛﺎﭘﻼﻥ‬
‫ﻭ ﻫﻤﻜﺎﺭﺍﻧﺶ )ﻛﺎﭘﻼﻥ‪ ،‬ﺷﻴﻮﻟﻰ‪ ،‬ﻓﻮﻧﺘﻨﻮﺕ‪ ،‬ﻣﻮﺭﮔﺎﻥ‪ ،‬ﻫﺎﻭﻝ‪ ،‬ﻣﺎﻧﻮﻙ‪ ،‬ﻣﻮﻟﺪﻡ‬
‫ﻭ ﻣﺎﻥ ‪ (1994‬ﺑﺮ ﺭﻭﻯ ﻣﻴﻤﻮﻥﻫﺎ ﺑﻴﺸﺘﺮ ﺍﺯ ﺗﻐﻴﻴﺮ ﺧﻠﻖ ﺑﻪ ﻭﺍﺳﻄﻪ ﺗﻐﻴﻴﺮﺍﺕ‬
‫ﺍﻳﺠﺎﺩ ﺷﺪﻩ ﺩﺭ ﻋﻮﺍﻣﻞ ﺗﻐﺬﻳﻪﺍﻯ ﻭ ﻧﺘﺎﻳﺞ ﺣﺎﺻﻞ ﺍﺯ ﺁﻥ ﺑﺮ ﻧﻴﻤﺮﺥ ﭼﺮﺑﻰ ﺧﻮﻥ‬
‫ﺣﻤﺎﻳﺖ ﻣﻰﻧﻤﺎﻳﻨﺪ ﺗﺎ ﺭﺍﺑﻄﻪ ﻋﻜﺲ ﺁﻥ ﺑﺎ ﺍﻳﻦ ﻭﺟﻮﺩ ﺑﺮﺭﺳﻰ ﻓﺮﺿﻴﻪﻫﺎﻱ‬
‫ﻣﻄﺮﻭﺣﻪ ﻧﻴﺎﺯﻣﻨﺪ ﻣﻄﺎﻟﻌﺎﺕ ﭘﻴﭽﻴﺪﻩﺗﺮ ﻭ ﺩﻗﻴﻖﺗﺮﻯ ﻣﻰﺑﺎﺷﺪ‪ .‬ﭘﮋﻭﻫﺶ ﺣﺎﺿﺮ‬
‫ﺭﺍﺑﻄﻪ ﻣﻴﺎﻥ ﺳﻄﻮﺡ ﻛﻠﺴﺘﺮﻭﻝ ﺧﻮﻥ ﻭ ﻣﻴﺰﺍﻥ ﺍﻓﺴﺮﺩﮔﻰ ﺍﻓﺮﺍﺩ ﺭﺍ ﻣﻮﺭﺩ ﺗﺎﻳﻴﺪ‬
‫ﻗﺮﺍﺭ ﺩﺍﺩﻩ ﺍﺳﺖ ﺑﺎ ﺍﻳﻦ ﻭﺟﻮﺩ ﺑﺎ ﺗﻮﺟﻪ ﺑﻪ ﻃﺮﺡ ﺗﺤﻘﻴﻖ‪ ،‬ﺍﻣﻜﺎﻥ ﺗﻔﺴﻴﺮ ﻋﻠﻰ‬
‫ﻧﺘﺎﻳﺞ ﻣﻤﻜﻦ ﻧﻤﻰﺑﺎﺷﺪ ﻭ ﺗﻨﻬﺎ ﺑﺎ ﺍﺳﺘﻨﺎﺩ ﺑﻪ ﻣﻄﺎﻟﻌﺎﺕ ﺁﺯﻣﺎﻳﺸﮕﺎﻫﻰ ﻧﻈﻴﺮ‬
‫ﻣﻄﺎﻟﻌﺎﺕ ﺍﻧﺠﺎﻡ ﺷﺪﻩ ﺗﻮﺳﻂ ﻛﺎﭘﻼﻥ ﻭ ﻫﻤﻜﺎﺭﺍﻧﺶ ﻣﻰﺗﻮﺍﻥ ﻓﺮﺽﻫﺎﻳﻰ‬
‫ﺟﻬﺖ ﺗﺒﺒﻴﻦ ﻧﺘﺎﻳﺞ ﺑﺪﺳﺖ ﺁﻣﺪﻩ ﺍﺭﺍﺋﻪ ﻧﻤﻮﺩ‪.‬‬
‫ﺧﻮﻥ ﺩﺭ ﺣﺪ ﻣﺘﻮﺳﻂ ﻭ ﺑﺎﻻ‪ ،‬ﭘﺎﻳﻴﻦﺗﺮ ﺑﻮﺩ‪ .‬ﺩﺭ ﻫﻤﻴﻦ ﺭﺍﺳﺘﺎ ﻣﻮﺭﮔﺎﻥ ﻭ‬
‫ﻊ‬
‫ﻣﻨﺎﺑﻊ‬
‫‪Almeida-Montes,‬‬ ‫‪L.G.,Valles-Sanchez,V.‬‬ ‫‪Moreno-‬‬
‫‪Aguilar, J., Chavez-Balderas, R. A., Garcia-Marin, J.‬‬
‫‪A., Cortes-Sotres, J. F., & Hheinze-Martin, G. (2000).‬‬
‫‪Relation of serum cholesterol, lipid,serotonin and‬‬
‫‪tryptophan levels to severity of depression and to sucide‬‬
‫‪attempers. Journal of Psychiatry & Neuroscience,‬‬
‫‪25,371-378.‬‬
‫‪Atmaca, M., Kuloglu, M.E., Tezcan, Ustundag, B., Gecici,‬‬
‫‪O., & Firidin, B. (2002). Serum leptin and cholesterol‬‬
‫‪values in suicide attempters. Neuropsychobiology, 45,‬‬
‫‪124–127.‬‬
‫‪Beck, A. T., Rush, A. J., Shaw, B. F., & Emery, G. (1979).‬‬
‫‪Cognitive therapy of depression: a treatment manual.‬‬
‫‪New York: Guilford.‬‬
‫‪Beck, A. T., & Steer, R. A. (1993). Beck Depression‬‬
‫‪Inventory Manual. The Psychological Corporation.‬‬
‫‪Harcourt Brace & Company. San Antonio.‬‬
‫‪Boston, P.F., Dursun, S.M., & Reveley, MA.(1996).‬‬
‫‪1- 5-hidroxy-indole-acetic acid‬‬
‫‪2- 3-metoxy-4 hydroxyphenyl-glycol‬‬
‫‪3 - homovanillic acid‬‬
‫‪7- monoaminergic‬‬
‫ﺑﺮﺭﺳﻰ ﺭﺍﺑﻄﻪ ﺳﻄﻮﺡ ﭼﺮﺑﻲﻫﺎ ﻭ ﻟﻴﭙﻮﭘﺮﻭﺗﺌﻲﻫﺎﻱ ﺧﻮﻥ ﺑﺎ ﺍﻓﺴﺮﺩﮔﻲ‬
‫ﻣﻐﺰﻯ ﻧﺨﺎﻋﻰ ﻳﺎﻓﺖ ﻣﻰﮔﺮﺩﺩ( ﺑﻪ ﺑﺮﺭﺳﻰ ﺗﺎﺛﻴﺮ ﺳﻄﻮﺡ ﻛﻠﺴﺘﺮﻭﻝ ﺧﻮﻥ ﺑﺮ‬
‫ﻓﻌﺎﻟﻴﺖ ﺳﻴﺴﺘﻢﻫﺎﻯ ﺳﺮﺗﻮﻧﺮژﻳﻚ‪ ،‬ﻧﻮﺭﺁﺩﺭﻧﺮژﻳﻚ ﻭ ﺩﻭﭘﺎﻣﻴﻨﺮژﻳﻚ ﭘﺮﺩﺍﺧﺘﻨﺪ‪.‬‬
‫ﺑﺪﻳﻦ ﻣﻨﻈﻮﺭ ﻃﻰ ﺩﻭ ﻣﺮﺣﻠﻪ ﭘﺲ ﺍﺯ ﺁﻧﻜﻪ ﻣﻴﻤﻮﻥﻫﺎ ﺑﻪ ﻣﺪﺕ ‪ 6‬ﻣﺎﻩ ﺍﺯ‬
‫ﺭژﻳﻢﻫﺎﻯ ﻏﺬﺍﻳﻰ ﻛﻢ ﭼﺮﺑﻰ ﻭ ﭘﺮﭼﺮﺑﻰ ﺍﺳﺘﻔﺎﺩﻩ ﻛﺮﺩﻧﺪ‪ 1 ،‬ﺍﻟﻰ ‪ 2‬ﻣﻴﻠﻰﻟﻴﺘﺮ ﺍﺯ‬
‫ﻣﺎﻳﻊ ﻣﻐﺰﻯ ﻧﺨﺎﻋﻰ ﺷﺎﻥ ﺟﻬﺖ ﺳﻨﺠﺶ ﻏﻠﻈﺖ ﻣﻮﺍﺩ ﺳﻮﺧﺖ ﻭ ﺳﺎﺯ ﺷﺪﻩ‬
‫ﺳﺮﻭﺗﻮﻧﻴﻦ )‪ 5‬ﻫﻴﺪﺭﻭﻛﺴﻰ ﺍﻳﻨﺪﻭﻝ ﺍﺳﺘﻴﻚ‪ ،(1‬ﻧﻮﺭﺍﭘﻰ ﻧﻔﺮﻳﻦ )‪ 3‬ﻣﺘﻮﻛﺴﻰ ‪4‬‬
‫ﻫﻴﺪﺭﻭﻛﺴﻰ ﻓﻨﻴﻞ ﮔﻠﻴﻜﻮﻝ(‪ 2‬ﻭ ﺩﻭﭘﺎﻣﻴﻦ )ﺍﺳﻴﺪ ﻫﻮﻣﻮ ﻭﺍﻧﻴﻠﻴﻚ(‪ ،3‬ﺍﺳﺘﺨﺮﺍﺝ‬
‫ﮔﺮﺩﻳﺪ ﻛﻪ ﺍﺯ ﺑﻴﻦ ﺁﻧﻬﺎ ﻏﻠﻈﺖﻫﺎﻯ ﺳﺮﻭﺗﻮﻧﻴﻦ ﺩﺭ ﻣﺎﻳﻊ ﻣﻐﺰﻯ ﻧﺨﺎﻋﻰ‬
‫ﮔﺮﻭﻫﻰ ﻛﻪ ﺍﺯ ﺭژﻳﻢ ﻏﺬﺍﻳﻰ ﻛﻢ ﭼﺮﺑﻰ ﺍﺳﺘﻔﺎﺩﻩ ﻣﻰﻛﺮﺩﻧﺪ ﻭ ﺳﻄﺢ ﻛﻠﺴﺘﺮﻭﻝ‬
‫ﺧﻮﻥﺷﺎﻥ ﭘﺎﻳﻴﻦﺗﺮ ﺑﻮﺩ ﺑﻪ ﻃﻮﺭ ﻣﻌﻨﺎﺩﺍﺭﻯ ﭘﺎﻳﻴﻦﺗﺮ ﺍﺯ ﻫﻤﺘﺎﻳﺎﻥﺷﺎﻥ ﺩﺭ ﮔﺮﻭﻫﻰ‬
‫ﺑﻮﺩ ﻛﻪ ﺍﺯ ﺭژﻳﻢ ﭘﺮﭼﺮﺑﻰ ﺍﺳﺘﻔﺎﺩﻩ ﻣﻰﻛﺮﺩﻧﺪ ﻭ ﺳﻄﺢ ﻛﻠﺴﺘﺮﻭﻝ ﺧﻮﻥﺷﺎﻥ‬
‫ﺑﺎﻻﺗﺮ ﺑﻮﺩ‪ .‬ﻏﻠﻈﺖﻫﺎﻯ ﻣﺮﺑﻮﻁ ﺑﻪ ﺳﺎﻳﺮ ﻣﺘﺎﺑﻮﻟﻴﺖﻫﺎﻯ ﻣﻮﻧﻮﺁﻣﻴﻨﺮژﻳﻚ ﻳﻌﻨﻰ‬
‫ﻧﻮﺭﺍﭘﻰﻧﻔﺮﻳﻦ ﻭ ﺩﻭﭘﺎﻣﻴﻦ ﺑﻴﻦ ﺩﻭ ﮔﺮﻭﻩ ﻣﺘﻔﺎﻭﺕ ﺑﻪ ﻟﺤﺎﻅ ﺳﻄﻮﺡ ﻛﻠﺴﺘﺮﻭﻝ ﻭ‬
‫ﭼﺮﺑﻰ ﺧﻮﻥ ﺍﺧﺘﻼﻑ ﻣﻌﻨﺎﺩﺍﺭﻯ ﺑﺎ ﻳﻜﺪﻳﮕﺮ ﻧﺪﺍﺷﺘﻨﺪ‪ .‬ﺩﺭ ﻭﺍﻗﻊ ﻧﺘﺎﻳﺞ ﻣﻄﺎﻟﻌﺎﺕ‬
‫ﺍﻧﺠﺎﻡ ﺷﺪﻩ ﺗﻮﺳﻂ ﺍﻳﻦ ﻣﺤﻘﻘﻴﻦ ﺳﻄﻮﺡ ﭘﺎﻳﻴﻦ ﭼﺮﺑﻰ ﻳﺎ ﻛﻠﺴﺘﺮﻭﻝ ﺧﻮﻥ ﺭﺍ ﺑﺎ‬
‫ﻛﺎﻫﺶ ﻓﻌﺎﻟﻴﺖ ﺳﻴﺴﺘﻢ ﺳﺮﺗﻮﻧﺮژﻳﻚ ﻣﺮﺗﺒﻂ ﻣﻰﺳﺎﺧﺖ‪ .‬ﺍﻧﺪﻟﺒﺮگ )‪(1992‬‬
‫ﺑﺮﺍﺳﺎﺱ ﺍﻃﻼﻋﺎﺕ ﻣﻮﺟﻮﺩ ﺍﻳﻦ ﻓﺮﺽ ﺭﺍ ﻣﻄﺮﺡ ﻧﻤﻮﺩﻩ ﺍﺳﺖ ﻛﻪ ﻛﺎﻫﺶ‬
‫ﻓﻌﺎﻟﻴﺖ ﺳﻴﺴﺘﻢ ﺳﺮﺗﻮﻧﺮژﻳﻚ ﺑﻪ ﻭﺍﺳﻄﻪ ﻓﺮﺍﻳﻨﺪﻯ ﻛﻪ ﻣﻮﺭﺩ ﺍﺷﺎﺭﻩ ﻗﺮﺍﺭ ﮔﺮﻓﺖ‬
‫ﻣﻨﺠﺮ ﺑﻪ ﻛﺎﻫﺶ ﻛﻨﺘﺮﻝ ﺗﻜﺎﻧﻪ ﻣﻰﮔﺮﺩﺩ‪ ،‬ﻛﻪ ﻣﻤﻜﻦ ﺍﺳﺖ ﺧﻮﺩ ﺭﺍ ﺑﻪ ﺻﻮﺭﺕ‬
‫ﺧﻮﺩﻛﺸﻰ‪ ،‬ﺭﻓﺘﺎﺭﻫﺎﻯ ﭘﺮﺧﺎﺷﮕﺮﺍﻧﻪ‪ ،‬ﻳﺎ ﺭﻓﺘﺎﺭﻫﺎﻯ ﻣﺴﺘﻌﺪ ﺧﻮﺩﻛﺸﻰ ﻧﻈﻴﺮ‬
‫ﺍﻓﺴﺮﺩﮔﻰ‪ ،‬ﻧﻤﺎﻳﺎﻥ ﺳﺎﺯﺩ‪ .‬ﺍﺳﺘﻴﮕﻤﻦ‪ 2‬ﻧﻴﺰ ﺑﻪ ﺳﺎﻝ ‪ 1996‬ﻃﻰ ﻣﻄﺎﻟﻌﻪﺍﻯ‬
‫ﻧﺸﺎﻥ ﺩﺍﺩ ﻛﻪ ﻣﻴﺰﺍﻥ ﺳﺮﻭﺗﻮﻧﻴﻦ ﺩﺭ ﻣﺮﺩﺍﻥ ﻣﻴﺎﻧﺴﺎﻟﻰ ﻛﻪ ﺳﻄﻮﺡ ﻛﻠﺴﺘﺮﻭﻝ‬
‫ﺧﻮﻥﺷﺎﻥ ﺑﻪ ﻃﻮﺭ ﺛﺎﺑﺘﻰ ﭘﺎﻳﻴﻦ ﺑﻮﺩ ﺩﺭ ﻣﻘﺎﻳﺴﻪ ﺑﺎ ﺍﻓﺮﺍﺩﻯ ﺑﺎ ﺳﻄﺢ ﻛﻠﺴﺘﺮﻭﻝ‬
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‫ﻫﻤﻜﺎﺭﺍﻧﺶ )ﻣﻮﺭﮔﺎﻥ‪ ،‬ﭘﺎﻟﻴﻨﻜﺎﺱ‪ ،‬ﺑﺎﺭﺕ ﻛﺮﻧﺮ ﻭ ﻫﻤﻜﺎﺭﺍﻥ‪ (1993 ،‬ﻧﻴﺰ ﺧﻄﺮ‬
‫ﺷﻜﻞﮔﻴﺮﻯ ﻧﺸﺎﻧﻪﻫﺎﻯ ﺍﻓﺴﺮﺩﮔﻰ ﺑﺮ ﻃﺒﻖ ﺳﻄﻮﺡ ﺍﻭﻟﻴﻪ ﻛﻠﺴﺘﺮﻭﻝ ﺧﻮﻥ‬
‫ﺭﺍ ﻃﻰ ﻳﻚ ﺩﻭﺭﻩ ﭘﻴﮕﻴﺮﻯ ‪ 10‬ﺗﺎ ‪ 15‬ﺳﺎﻟﻪ ﺩﺭ ‪ 1020‬ﻣﺮﺩ‪ 50،‬ﺗﺎ ‪ 89‬ﺳﺎﻟﻪ‬
‫ﺑﺮﺭﺳﻰ ﻧﻤﻮﺩﻧﺪ ﻭ ﻧﺸﺎﻥ ﺩﺍﺩﻧﺪ ﻛﻪ ﻣﺮﺩﺍﻥ ‪ 70‬ﺳﺎﻟﻪ ﻳﺎ ﻣﺴﻦﺗﺮﻯ ﻛﻪ ﺳﻄﺢ‬
‫ﻛﻠﺴﺘﺮﻭﻝ ﺧﻮﻥﺷﺎﻥ ﭘﺎﻳﻴﻦﺗﺮ ﺍﺯ ‪160‬ﻣﻴﻠﻰ ﮔﺮﻡ ﺩﺭ ﻟﻴﺘﺮ ﺑﻮﺩ ﺩﺭ ﻣﻘﺎﻳﺴﻪ ﺑﺎ‬
‫ﻣﺮﺩﺍﻧﻰ ﻛﻪ ﺳﻄﺢ ﻛﻠﺴﺘﺮﻭﻝ ﺧﻮﻥﺷﺎﻥ ‪ 160‬ﻣﻴﻠﻰ ﮔﺮﻡ ﺩﺭ ﻟﻴﺘﺮ ﻳﺎ ﺑﺎﻻﺗﺮ ﺑﻮﺩ‬
‫ﺳﻪ ﺑﺮﺍﺑﺮ ﺑﻴﺸﺘﺮ ﺩﺭ ﻣﻌﺮﺽ ﺍﻓﺴﺮﺩﮔﻰ ﻗﺮﺍﺭ ﺩﺍﺷﺘﻨﺪ‪ .‬ﺗﻐﻴﻴﺮﺍﺕ ﻣﺸﺎﻫﺪﻩ ﺷﺪﻩ‬
‫ﺗﻮﺳﻂ ﺍﻳﻦ ﻣﺤﻘﻘﻴﻦ ﻧﻴﺰ ﻧﻈﻴﺮ ﭘﮋﻭﻫﺶ ﻛﻨﻮﻧﻰ ﻣﺴﺘﻘﻞ ﺍﺯ ﺳﻦ‪ ،‬ﻭﺿﻌﻴﺖ‬
‫ﺳﻼﻣﺖ‪ ،‬ﺑﻴﻤﺎﺭﻯﻫﺎﻯ ﻣﺰﻣﻦ‪ ،‬ﺩﺍﺭﻭﻫﺎﻯ ﻣﺼﺮﻓﻰ ﻭ ﺗﻐﻴﻴﺮ ﻛﻠﺴﺘﺮﻭﻝ ﻃﻰ‬
‫ﺩﻭﺭﻩ ﭘﻰﮔﻴﺮﻯ ﺑﻮﺩ‪.‬‬
‫ﺩﺭ ﺭﺍﺳﺘﺎﻱ ﺗﻼﺵ ﺟﻬﺖ ﺗﺒﻴﻴﻦ ﺭﺍﺑﻄﻪ ﻣﻴﺎﻥ ﭼﺮﺑﻲﻫﺎﻱ ﺧﻮﻥ‪ ،‬ﺧﺼﻮﺻ ًﺎ‬
‫ﻛﻠﺴﺘﺮﻭﻝ‪ ،‬ﻭ ﺍﻓﺴﺮﺩﮔﻲ‪ ،‬ﺑﺮﺧﻰ ﺗﺤﻘﻴﻘﺎﺕ ﺗﻐﻴﻴﺮﺍﺗﻰ ﺭﺍ ﺩﺭ ﻣﺘﺎﺑﻮﻟﻴﺴﻢ‬
‫ﭼﺮﺑﻰﻫﺎﻯ ﺧﻮﻥ ﺑﻴﻤﺎﺭﺍﻥ ﻣﺒﺘﻼ ﺑﻪ ﺍﻓﺴﺮﺩﮔﻰ ﻧﺸﺎﻥ ﺩﺍﺩﻩﺍﻧﺪ )ﻣﺎﺯ‪ ،‬ﺩﻻﻧﮕﻪ‪،‬‬
‫ﻣﻠﺘﺰﺭ‪ ،‬ﺍﺳﭽﺎﺭﭘﻪ ﻭ ﻫﻤﻜﺎﺭﺍﻥ‪ .(1994،‬ﺩﺭ ﻭﺍﻗﻊ ﺍﻳﻦ ﻣﺤﻘﻘﻴﻦ ﺩﺭ ﺑﺮﺭﺳﻲﻫﺎﻯ‬
‫ﺧﻮﻳﺶ ﺟﻬﺖ ﺗﺒﻴﻴﻦ ﺭﺍﺑﻄﻪ ﺑﻴﻦ ﭼﺮﺑﻰﻫﺎﻯ ﺧﻮﻥ ﻭ ﺍﻓﺴﺮﺩﮔﻰ‪ ،‬ﻛﺎﻫﺶ‬
‫ﻓﻌﺎﻟﻴﺖ ﺁﻧﺰﻳﻢ ﻟﻜﺘﻴﻦ‪ :‬ﻛﻠﺴﺘﺮﻭﻝ ﺍﺳﺘﻴﻞ ﺗﺮﺍﻧﺴﻔﺮﺍﺯ‪ (LCAT)4‬ﺭﺍ ﻣﺪ ﻧﻈﺮ‬
‫ﻗﺮﺍﺭ ﺩﺍﺩﻩﺍﻧﺪ ﻛﻪ ﻣﻨﺠﺮ ﺑﻪ ﻛﺎﻫﺶ ﺷﻜﻞﮔﻴﺮﻯ ﻛﻠﺴﺘﺮﻭﻝﻫﺎﻯ ﺍﺳﺘﺮﻳﻞ‬
‫ﻣﻰﮔﺮﺩﺩ‪ ،‬ﻛﻪ ﺧﻮﺩ ﻣﻰﺗﻮﺍﻧﺪ ﺩﺭ ﺭﺍﺑﻄﻪ ﺑﺎ ﺍﻳﺠﺎﺩ ﺍﻓﺴﺮﺩﮔﻰ ﺣﺎﺋﺰ ﺍﻫﻤﻴﺖﺗﺮ‬
‫‪5‬‬
‫ﺍﺯ ﺳﻄﻮﺡ ﻛﻠﺴﺘﺮﻭﻝ ﺧﻮﻥ ﺑﻪ ﺗﻨﻬﺎﻳﻰ ﺑﺎﺷﺪ‪ .‬ﻛﮋﻛﻨﺸﻰ ﺩﺭ ﺍﺳﺘﺮﻓﻴﻜﻴﺸﻦ‬
‫‪4- lecithin: cholesterol acyl transferase‬‬
‫‪5- esterification‬‬
‫‪6- microviscosity‬‬
 ‫ﻃﺒﺎﻃﺒﺎﺋﻲ ﻭ ﻫﻤﻜﺎﺭﺍﻥ‬
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