Benefits of Physical Activity

Benefits of physical activity

From Wikipedia, the free encyclopedia

The benefits of physical activity are improvements in health and well-being that result from physical activity.

Though people often use the terms "physical activity" and exercise interchangeably, the terms have different meanings. “Physical activity” refers to any body movement that burns calories, whether it’s for work or play, going to the gym, daily chores, or the daily commute. “Exercise,” a subcategory of physical activity, refers to planned, structured, and repetitive activities aimed at improving physical fitness and health.[1] Exercise is a bodily activity that enhances or maintains physical fitness and overall health and wellness. Insufficient physical activity is the number one most common health issue in the world. Staying physically active can help prevent or delay certain diseases, including some cancers, heart disease and diabetes, and can also relieve depression and improve mood.[2]

A research Physical Activity Fundamental to Preventing Disease published by U.S. Department of Health & Human Services claims that virtually all individuals can benefit from regular physical activity, whether they participate in vigorous exercise or some type of moderate health-enhancing physical activity.[3]

Immediate benefits

Brain activity

The benefits of physical exercise, especially aerobic exercise or pilates, have positive effects on brain function on multiple fronts, ranging from the molecular to the behavioral level. According to a study conducted by the Department of Exercise Science at the University of Georgia, even briefly exercising for 20 minutes facilitates information processing and memory functions.[4]

Exercise affects the brain on multiple fronts. It increases the heart rate, which pumps more oxygen to the brain. It also aids the bodily release of a plethora of hormones, all of which participate in aiding and providing a nourishing environment for the growth of brain cells.[5]

Physical activity of any intensity is beneficial. It can enhance sleep, cognitive health, and quality of life, regardless of age or fitness level. It can lower the risk of cognitive decline, including dementia. Adults who are inactive have nearly twice as many cases of cognitive deterioration as adults who are active. It's recommended that the majority of adults engage in 150 minutes per week of physical activity of a moderate level. This can be divided into 5 days a week of daily, 30-minute sessions. [6]

Exercise stimulates brain plasticity by stimulating the growth of new connections between cells in a wide array of important cortical areas of the brain. Research from UCLA demonstrated that exercise increased growth factors in the brain, making it easier for the brain to grow new neuronal connections.[7]

Exercise can improve cognitive skills, decrease chances of dementia, and reduce damage and deterioration of brain tissue. Scientists believe that by maintaining physical fitness, it keeps the blood flowing normally to brain tissue.[8] When the blood flows normally to the brain tissue, it reduces the risk of damage and deterioration. Blood flow is very important when it comes to keeping the brain young and healthy. There have also been studies that show that aerobic exercise stimulates the release of growth hormones, which continues to improve brain function. When getting to a certain age, it is important that one exercises regularly to keep the brain strong and well functioning, rather than deteriorating.

The CDC website states, "Every little bit counts. Even some chores such as light yard work (raking and bagging leaves or using a lawn mower) and gardening can help you get active"[9]

Some of the benefits of physical activity on brain health happen right after a session of moderate-to-vigorous physical activity. Benefits include improved thinking or cognition for children ages 6-13 and reduced short-term feelings of anxiety for adults. Regular physical activity can keep thinking, learning, and judgment skills sharp with age. It can also reduce the risk of depression and anxiety and improve sleep.[10]

Weight management

Both diet and physical activity play a critical role in maintaining healthy body weight, losing excess body weight, or maintaining successful weight loss.[11] Physical activity helps control weight by using excess calories that would otherwise be stored as fat. Most foods consumed contain calories, and most activities burn calories, including sleeping, breathing, and digesting food. Balancing the calories consumed with the calories used through physical activity can help someone reach and maintain a healthy weight.[12]

Muscle is crucial to the human body. Muscle is heavier than fat, so by losing fat and gaining an equal amount of muscle, one could gain weight. However, the body could appear slimmer and leaner.Physical activity is not only used for losing weight, but also for gaining weight. By having a high protein intake, one can put stress on muscle fibers, by doing an exercise regimen that will cause them to tear. This is why one may feel sore, as the muscle fibers are starting the process of tearing and healing. Once the muscle fibers heal, growth and gain in weight will appear. Because muscle mass is denser than fat mass, adding lean muscle can cause weight gain.

Long-term benefits

The most common health risks include cardiovascular diseases, diabetes type 2 and some cancers.[11]

Obesity is a complex disease that affects whole body metabolism and is associated with an increased risk of cardiovascular disease (CVD) and Type 2 diabetes (T2D). Physical exercise results in numerous health benefits and is an important tool to combat obesity and its co-morbidities, including cardiovascular disease. Exercise prevents both the onset and development of cardiovascular disease and is an important therapeutic tool to improve outcomes for patients with cardiovascular disease. Some benefits of exercise include enhanced mitochondrial function, restoration and improvement of vasculature, and the release of myokines from skeletal muscle that preserve or augment cardiovascular function. In this review, we will discuss the mechanisms through which exercise promotes cardiovascular health. Regular physical exercise has several beneficial effects on overall health. While decreasing body mass and adiposity are not the primary outcomes of exercise, exercise can mediate several diseases that accompany obesity, including T2D and CVD. Several recent studies have shown that sustained physical activity is associated with decreased markers of inflammation, improved metabolic health, decreased risk of heart failure, and improved overall survival.[13][14][15] There are several risk factors leading to the development and progression of CVD, but one of the most prominent is a sedentary lifestyle. A sedentary lifestyle can be characterized by both obesity and consistently low levels of physical activity. Thus, lifestyle interventions that aim to increase physical activity and decrease obesity are attractive therapeutic methods to combat most non-congenital types of CVD.[16]

Cardiovascular Risk Factors

Regular physical exercise is associated with numerous health benefits to reduce the progression and development of obesity, T2D, and CVD. Several randomized clinical trials have demonstrated that lifestyle interventions, including moderate exercise and a healthy diet, improve cardiovascular health in at-risk populations. Individuals with metabolic syndrome who participated in a 4-month program of either a diet (caloric restriction) or exercise intervention had reduced adiposity, decreased systolic, diastolic and mean arterial blood pressure, and lower total and low-density lipoprotein (LDL) cholesterol lipid profiles compared to the control group. Both the diet and exercise intervention improve these cardiovascular outcomes to a similar extent.[17]

Several previous studies have investigated the effects of diet and exercise, independently or in combination, on metabolic and cardiovascular health and have determined that diet, exercise, or a combination of diet and exercise induces weight loss, decreases visceral adiposity, lowers plasma triglycerides, plasma glucose, HDL levels, and blood pressure, and improves VO2max. Importantly, several of these beneficial effects of exercise are evident independent of weight loss. Studies have shown that exercise can improve metabolic and cardiovascular health independent of changes in body weight, including improved glucose homeostasis, endothelial function, blood pressure, and HDL levels. These data indicate exercise, independent of changes in body mass, results in significant improvements in cardiovascular and metabolic health. Although a detailed analysis of the vast impact of diet on cardiometabolic health is outside the scope of this review, the importance of diet and exercise in tandem should not be ignored, as many studies have shown that cardiometabolic health is improved to a higher extent in response to a combined diet and exercise programs compared to either intervention alone.[17]

Exercise has a similar effect on cardiovascular improvements in lean and overweight normoglycemic subjects. In a 1-year study of non-obese individuals, a 16–20% increase in energy expenditure (of any form of exercise) with no diet intervention resulted in a 22.3% decrease in body fat mass and reduced LDL cholesterol, total cholesterol/HDL ratio, and C-reactive protein concentrations, all risk factors associated with CVD. In overweight individuals, 7–9 months of low-intensity exercise (walking ~19 km per week at 40–55% VO2peak) significantly increased cardiorespiratory fitness compared to sedentary individuals. Together these data indicate that exercise interventions decrease the risk or severity of CVD in subjects who are lean, obese, or have type 2 diabetes.[17]

Cardiac rehabilitation

Exercise is also an important therapeutic treatment for patients who have cardiovascular diseases. A systematic review of 63 studies found that exercise-based cardiac rehabilitation improved cardiovascular function. These studies consisted of various forms of aerobic exercise at a range of intensities (from 50 to 95% VO2), over a multitude of time periods (1–47 months). Overall, exercise significantly reduced CVD-related mortality, decreased risk of MI, and improved quality of life. Another study looked specifically in patients with atherosclerosis post-revascularization surgery. Patients who underwent 60 min of exercise per day on a cycle ergometer for 4 weeks had an increase blood flow reserve (29%) and improved endothelium-dependent vasodilatation. A recent study provided personalized aerobic exercise rehabilitation programs for patients who had an acute myocardial infarction for 1 year after a coronary intervention surgery. The patients who underwent the exercise rehabilitation program had increased ejection fraction (60.81 vs. 53% control group), increased exercise tolerance, and reduced cardiovascular risk factors 6 months after starting the exercise rehabilitation program. This improvement in cardiovascular health in patients with atherosclerosis or post-MI is likely the result of increased myocardial perfusion in response to exercise, however, more research is required to fully understand these mechanisms.[18]

One defining characteristic of heart failure is exercise intolerance, which resulted in a prescription of bed rest for these patients until the 1950s. However, it has now been shown that a monitored rehabilitation program using moderate intensity exercise is safe for heart failure patients, and this has now become an important therapeutic for patients with heart failure. Meta-analyses and systemic reviews have shown that exercise training in heart failure patients is associated with improved quality of life, reduced risk of hospitalization and decreased rates of long-term mortality. One study of heart failure patients found that aerobic exercise (walking or cycling) at 60–70% of heart rate reserve 3–5 times per week for over 3 years led to improved health and overall quality of life (determined by a self-reported Kansas City Cardiomyopathy Questionnaire, a 23-question disease-specific questionnaire). Other studies have shown that exercise-based rehabilitation at a moderate intensity in heart failure patients improves cardiorespiratory fitness and increases both exercise endurance capacity and VO2max (12–31% increase).[18]

More recent studies have examined the effects of high-intensity exercise on patients with heart failure. A recent study found that 12 weeks of high-intensity interval training (HIIT) in heart failure patients (with reduced ejection fraction) was well-tolerated and had similar benefits compared to patients who underwent moderate continuous exercise (MCE) training, including improved left ventricular remodeling and aerobic capacity. A separate study found that 4 weeks of HIIT in heart failure patients with preserved ejection fraction improved VO2peak and reduced diastolic dysfunction compared to both pre-training values and compared to the MCE group. These studies indicate that both moderate and high intensity exercise training improve cardiovascular function in heart failure patients, likely related to increased endothelium-dependent vasodilation and improved aerobic capacity.[18]

Other benefits

Bones and muscles

Routine physical activity is important for building strong bones and muscles in children, but it is equally important with older adults. Bones and muscles work together to support daily movements. Physical activity strengthens muscles. Bones adapt by building more cells, and as a result, both become stronger. Strong bones and muscles protect against injury and improves balance and coordination. In addition, active adults experience less joint stiffness and improved flexibility. This becomes especially important with age, as it helps to prevent falls and the broken bones that may result. For those with arthritis, exercise that keeps the muscles around the joint strong can act like a brace that will react to movement without the use of an actual brace.[19]

Daily activity

The ability to perform daily activities and maintain independence requires strong muscles, balance and endurance. Regular physical activity or exercise helps to improve and prevent the decline of muscle strength, balance and endurance, all risk factors for falling. Balance plays an important role in everyday activities such as walking, getting up out of a chair or leaning over to pick something up. Balance problems can reduce independence by interfering with activities of daily living. Regular physical activity can improve balance and reduce the risk of falling.[20]

Cancer

Exercise increases the chances of surviving cancer. If one exercise during the early stages of cancer treatment it may allow time to reduce the detrimental side effects of the chemotherapy. It also improves physical functions along with reducing distress and fatigue.[21] Studies have shown that exercise has the possibility to improve the chemotherapy drug uptake, thanks to the increase in the peripheral circulation.[21] This also makes changes to tumors vasculature from the increase of cardio and blood pressure.

Sleep

Exercise triggers an increase in body temperature, and the post-exercise drop in temperature may promote falling asleep. Exercise may also reduce insomnia by decreasing arousal, anxiety and depressive symptoms. Insomnia is commonly linked with elevated arousal, anxiety, and depression, and exercise has effects on reducing these symptoms in the general population.[22] These issues count among the most common among most of population. Anxiety disorders are the most common mental illness in the U.S., affecting 40 million adults in the United States age 18 and older, or 18.1% of the population every year.[23] A 2010 review suggested that exercise generally improved sleep for most people, and may help with insomnia, but there is insufficient evidence to draw detailed conclusions about the relationship between exercise and sleep.[24][25] A 2020 systematic review and meta-analysis suggested that physical activity has little association with sleep in healthy children.[26] However, there have been several research findings indicating that certain forms of physical activity can improve the quality and duration of sleep.[27] In fact, a 2019 study at The Federal University of Sรฃo Paulo concluded that moderate physical activity resulted in an increase in sleep efficiency and duration in adults diagnosed with insomnia.[28] The duration refers to the hours of sleep a person gets on a nightly basis, while the quality indicates how well or sufficient it was.[29] Having poor sleep quality can lead to negative short term consequences like emotional distress and performance deficits. The psychosocial issues associated with these consequences can vary between adults, adolescents, and children. Some of the long term effects of poor sleep quality can lead to conditions like hypertension, metabolic syndrome, and even weight-related issues.[30]

Benefits of physical activity - Wikipedia


Category:Physical exercise

From Wikipedia, the free encyclopedia
Jump to navigationJump to search

Subcategories

This category has the following 36 subcategories, out of 36 total.

A

B

C

D

E

F

G

H

J

O

P

R

S

T

W

Y

Pages in category "Physical exercise"

The following 195 pages are in this category, out of 195 total. This list may not reflect recent changes.


เธซเธกเธงเธ”เธซเธกู่:เธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธข

เธˆเธฒเธเธงิเธิเธžีเน€เธ”ีเธข เธชเธฒเธฃเธฒเธ™ุเธเธฃเธกเน€เธชเธฃี
เน„เธ›เธขัเธ‡เธเธฒเธฃเธ™ํเธฒเธ—เธฒเธ‡เน„เธ›เธขัเธ‡เธเธฒเธฃเธ„้เธ™เธซเธฒ

เธ›เธฃเธฐเน€เธ เธ—เธข่เธญเธข

เธซเธกเธงเธ”เธซเธกู่เธ™ี้เธกีเธซเธกเธงเธ”เธซเธกู่เธข่เธญเธข 36 เธ›เธฃเธฐเน€เธ เธ—เธ•่เธญเน„เธ›เธ™ี้ เธˆเธฒเธเธ—ั้เธ‡เธซเธกเธ” 36 เธ›เธฃเธฐเน€เธ เธ—

R

เธซเธ™้เธฒเนƒเธ™เธซเธกเธงเธ”เธซเธกู่ "เธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธข"

เธซเธ™้เธฒ 195 เธ•่เธญเน„เธ›เธ™ี้เธญเธขู่เนƒเธ™เธซเธกเธงเธ”เธซเธกู่เธ™ี้ เธˆเธฒเธเธ—ั้เธ‡เธซเธกเธ” 195 เธซเธ™้เธฒ เธฃเธฒเธขเธเธฒเธฃเธ™ี้เธญเธฒเธˆเน„เธก่เธชเธฐเธ—้เธญเธ™เธ–ึเธ‡เธเธฒเธฃเน€เธ›เธฅี่เธขเธ™เนเธ›เธฅเธ‡เธฅ่เธฒเธชุเธ”

A

C

เนเธฅเธฐ

P

S


เธ›เธฃเธฐเน‚เธขเธŠเธ™์เธ‚เธญเธ‡เธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธข

เธˆเธฒเธเธงิเธิเธžีเน€เธ”ีเธข เธชเธฒเธฃเธฒเธ™ุเธเธฃเธกเน€เธชเธฃี
เน„เธ›เธขัเธ‡เธเธฒเธฃเธ™ํเธฒเธ—เธฒเธ‡เน„เธ›เธขัเธ‡เธเธฒเธฃเธ„้เธ™เธซเธฒ

เธ›เธฃเธฐเน‚เธขเธŠเธ™์เธ‚เธญเธ‡เธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธขเธ„ืเธญเธเธฒเธฃเธ›เธฃัเธšเธ›เธฃุเธ‡เธชุเธ‚เธ เธฒเธžเนเธฅเธฐเธ„เธงเธฒเธกเน€เธ›็เธ™เธญเธขู่เธ—ี่เธ”ีเธ‹ึ่เธ‡เน€เธ›็เธ™เธœเธฅเธกเธฒเธˆเธฒเธเธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธข

 

เนเธก้เธง่เธฒเธœู้เธ„เธ™เธกัเธเนƒเธŠ้เธ„ํเธฒเธง่เธฒ "เธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธข" เนเธฅเธฐเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธขเนเธ—เธ™เธัเธ™เน„เธ”้ เนเธ•่เธ„ํเธฒเธ™ี้เธกีเธ„เธงเธฒเธกเธซเธกเธฒเธขเธ•่เธฒเธ‡เธัเธ™ "เธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธข" เธซเธกเธฒเธขเธ–ึเธ‡เธเธฒเธฃเน€เธ„เธฅื่เธญเธ™เน„เธซเธงเธ‚เธญเธ‡เธฃ่เธฒเธ‡เธเธฒเธขเธ—ี่เน€เธœเธฒเธœเธฅเธฒเธเนเธ„เธฅเธญเธฃีเน„เธก่เธง่เธฒเธˆเธฐเน€เธ›็เธ™เน€เธžื่เธญเธเธฒเธฃเธ—ํเธฒเธ‡เธฒเธ™เธซเธฃืเธญเน€เธฅ่เธ™เธเธฒเธฃเน„เธ›เธขิเธกเธ‡เธฒเธ™เธ›เธฃเธฐเธˆํเธฒเธงัเธ™เธซเธฃืเธญเธเธฒเธฃเน€เธ”ิเธ™เธ—เธฒเธ‡เธ›เธฃเธฐเธˆํเธฒเธงัเธ™ "เธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธข" เธ‹ึ่เธ‡เน€เธ›็เธ™เธซเธกเธงเธ”เธซเธกู่เธข่เธญเธขเธ‚เธญเธ‡เธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธขเธซเธกเธฒเธขเธ–ึเธ‡เธิเธˆเธเธฃเธฃเธกเธ—ี่เธงเธฒเธ‡เนเธœเธ™เน„เธง้เธกีเน‚เธ„เธฃเธ‡เธชเธฃ้เธฒเธ‡เนเธฅเธฐเธ‹้ํเธฒ เน† เธ—ี่เธกุ่เธ‡เธ›เธฃัเธšเธ›เธฃุเธ‡เธชเธกเธฃเธฃเธ–เธ เธฒเธžเธ—เธฒเธ‡เธเธฒเธขเนเธฅเธฐเธชุเธ‚เธ เธฒเธž เธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธขเน€เธ›็เธ™เธิเธˆเธเธฃเธฃเธกเธ—เธฒเธ‡เธฃ่เธฒเธ‡เธเธฒเธขเธ—ี่เธŠ่เธงเธขเน€เธžิ่เธกเธซเธฃืเธญเธฃัเธเธฉเธฒเธชเธกเธฃเธฃเธ–เธ เธฒเธžเธ—เธฒเธ‡เธเธฒเธขเนเธฅเธฐเธชุเธ‚เธ เธฒเธžเน‚เธ”เธขเธฃเธงเธกเนเธฅเธฐเธ„เธงเธฒเธกเน€เธ›็เธ™เธญเธขู่เธ—ี่เธ”ี เธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธขเน„เธก่เน€เธžีเธขเธ‡เธžเธญเน€เธ›็เธ™เธ›ัเธเธซเธฒเธชุเธ‚เธ เธฒเธžเธ—ี่เธžเธšเธš่เธญเธขเธ—ี่เธชุเธ”เธญัเธ™เธ”ัเธšเธซเธ™ึ่เธ‡เธ‚เธญเธ‡เน‚เธฅเธ เธเธฒเธฃเธ„เธ‡เธ„เธงเธฒเธกเธเธฃเธฐเธ‰ัเธšเธเธฃเธฐเน€เธ‰เธ‡เธ—เธฒเธ‡เธฃ่เธฒเธ‡เธเธฒเธขเธชเธฒเธกเธฒเธฃเธ–เธŠ่เธงเธขเธ›้เธญเธ‡เธัเธ™เธซเธฃืเธญเธŠเธฐเธฅเธญเน‚เธฃเธ„เธšเธฒเธ‡เธŠเธ™ิเธ”เธฃเธงเธกเธ–ึเธ‡เธกเธฐเน€เธฃ็เธ‡เธšเธฒเธ‡เธŠเธ™ิเธ”เน‚เธฃเธ„เธซัเธงเนƒเธˆเนเธฅเธฐเน‚เธฃเธ„เน€เธšเธฒเธซเธงเธฒเธ™เนเธฅเธฐเธขัเธ‡เธชเธฒเธกเธฒเธฃเธ–เธšเธฃเธฃเน€เธ—เธฒเธ เธฒเธงเธฐเธ‹ึเธกเน€เธจเธฃ้เธฒเนเธฅเธฐเธ›เธฃัเธšเธ›เธฃุเธ‡เธญเธฒเธฃเธกเธ“์ [2]

เธเธฒเธฃเธงิเธˆัเธขเธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธขเธžื้เธ™เธเธฒเธ™เนƒเธ™เธเธฒเธฃเธ›้เธญเธ‡เธัเธ™เน‚เธฃเธ„เธ—ี่เธ•ีเธžิเธกเธž์เน‚เธ”เธขเธเธฃเธฐเธ—เธฃเธงเธ‡เธชเธฒเธ˜เธฒเธฃเธ“เธชุเธ‚เนเธฅเธฐเธšเธฃิเธเธฒเธฃเธกเธ™ุเธฉเธข์เธ‚เธญเธ‡เธชเธซเธฃัเธเธญเน€เธกเธฃิเธเธฒเธญ้เธฒเธ‡เธง่เธฒเนเธ—เธšเธ—ุเธเธ„เธ™เธชเธฒเธกเธฒเธฃเธ–เน„เธ”้เธฃัเธšเธ›เธฃเธฐเน‚เธขเธŠเธ™์เธˆเธฒเธเธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธขเน€เธ›็เธ™เธ›เธฃเธฐเธˆํเธฒเน„เธก่เธง่เธฒเธžเธงเธเน€เธ‚เธฒเธˆเธฐเธกีเธช่เธงเธ™เธฃ่เธงเธกเนƒเธ™เธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธขเธญเธข่เธฒเธ‡เธซเธ™ัเธเธซเธฃืเธญเธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธขเธ—ี่เน€เธชเธฃิเธกเธชเธฃ้เธฒเธ‡เธชุเธ‚เธ เธฒเธžเนƒเธ™เธฃเธฐเธ”ัเธšเธ›เธฒเธ™เธเธฅเธฒเธ‡เธšเธฒเธ‡เธ›เธฃเธฐเน€เธ เธ— [3]

เธ›เธฃเธฐเน‚เธขเธŠเธ™์เธ—ัเธ™เธ—ี

เธเธฒเธฃเธ—ํเธฒเธ‡เธฒเธ™เธ‚เธญเธ‡เธชเธกเธญเธ‡

เธ›เธฃเธฐเน‚เธขเธŠเธ™์เธ‚เธญเธ‡เธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธขเน‚เธ”เธขเน€เธ‰เธžเธฒเธฐเธญเธข่เธฒเธ‡เธขิ่เธ‡เธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธขเนเธšเธšเนเธญเน‚เธฃเธšิเธ„เธซเธฃืเธญเธžิเธฅเธฒเธ—ิเธชเธกีเธœเธฅเนƒเธ™เน€เธŠิเธ‡เธšเธงเธเธ•่เธญเธเธฒเธฃเธ—ํเธฒเธ‡เธฒเธ™เธ‚เธญเธ‡เธชเธกเธญเธ‡เนƒเธ™เธซเธฅเธฒเธข เน† เธ”้เธฒเธ™เธ•ั้เธ‡เนเธ•่เธฃเธฐเธ”ัเธšเน‚เธกเน€เธฅเธุเธฅเน„เธ›เธˆเธ™เธ–ึเธ‡เธฃเธฐเธ”ัเธšเธžเธคเธ•ิเธเธฃเธฃเธก เธˆเธฒเธเธเธฒเธฃเธจึเธเธฉเธฒเธ‚เธญเธ‡เธ เธฒเธ„เธงิเธŠเธฒเธงิเธ—เธขเธฒเธจเธฒเธชเธ•เธฃ์เธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธขเธ—ี่เธกเธซเธฒเธงิเธ—เธขเธฒเธฅัเธขเธˆเธญเธฃ์เน€เธˆีเธขเนเธก้เธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธขเธชั้เธ™ เน† เน€เธ›็เธ™เน€เธงเธฅเธฒ 20 เธ™เธฒเธ—ีเธˆเธฐเธŠ่เธงเธขเธญํเธฒเธ™เธงเธขเธ„เธงเธฒเธกเธชเธฐเธ”เธงเธเนƒเธ™เธเธฒเธฃเธ›เธฃเธฐเธกเธงเธฅเธœเธฅเธ‚้เธญเธกูเธฅเนเธฅเธฐเธเธฒเธฃเธ—ํเธฒเธ‡เธฒเธ™เธ‚เธญเธ‡เธซเธ™่เธงเธขเธ„เธงเธฒเธกเธˆํเธฒ [4]

เธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธขเธกีเธœเธฅเธ•่เธญเธชเธกเธญเธ‡เนƒเธ™เธซเธฅเธฒเธขเธ”้เธฒเธ™ เธกัเธ™เน€เธžิ่เธกเธญัเธ•เธฃเธฒเธเธฒเธฃเน€เธ•้เธ™เธ‚เธญเธ‡เธซัเธงเนƒเธˆเธ‹ึ่เธ‡เธ›ั๊เธกเธญเธญเธเธ‹ิเน€เธˆเธ™เน„เธ›เธขัเธ‡เธชเธกเธญเธ‡เธกเธฒเธเธ‚ึ้เธ™ เธ™เธญเธเธˆเธฒเธเธ™ี้เธขัเธ‡เธŠ่เธงเธขเธ›เธฅเธ”เธ›เธฅ่เธญเธขเธฃ่เธฒเธ‡เธเธฒเธขเธ‚เธญเธ‡เธฎเธญเธฃ์เน‚เธกเธ™เธกเธฒเธเธกเธฒเธขเน€เธซเธฅืเธญเน€เธŸืเธญเธ‹ึ่เธ‡เธ—ั้เธ‡เธซเธกเธ”เธ™ี้เธกีเธช่เธงเธ™เธฃ่เธงเธกเนƒเธ™เธเธฒเธฃเธŠ่เธงเธขเน€เธซเธฅืเธญเนเธฅเธฐเนƒเธซ้เธชเธ เธฒเธžเนเธงเธ”เธฅ้เธญเธกเธ—ี่เธšํเธฒเธฃุเธ‡เธชํเธฒเธซเธฃัเธšเธเธฒเธฃเน€เธˆเธฃิเธเน€เธ•ิเธšเน‚เธ•เธ‚เธญเธ‡เน€เธ‹เธฅเธฅ์เธชเธกเธญเธ‡ [5]

เธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธขเธ—ี่เธกีเธ„เธงเธฒเธกเธฃุเธ™เนเธฃเธ‡เนƒเธ” เน† เธˆเธฐเน€เธ›็เธ™เธ›เธฃเธฐเน‚เธขเธŠเธ™์ เธกัเธ™เธชเธฒเธกเธฒเธฃเธ–เน€เธžิ่เธกเธเธฒเธฃเธ™เธญเธ™เธซเธฅัเธš, เธชุเธ‚เธ เธฒเธžเธ—เธฒเธ‡เธ›ัเธเธเธฒ, เนเธฅเธฐเธ„ุเธ“เธ เธฒเธžเธŠีเธงิเธ•, เน‚เธ”เธขเน„เธก่เธ„ํเธฒเธ™ึเธ‡เธ–ึเธ‡เธญเธฒเธขุเธซเธฃืเธญเธฃเธฐเธ”ัเธšเธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธข. เธกัเธ™เธชเธฒเธกเธฒเธฃเธ–เธฅเธ”เธ„เธงเธฒเธกเน€เธชี่เธขเธ‡เธ‚เธญเธ‡เธเธฒเธฃเธฅเธ”เธฅเธ‡เธ‚เธญเธ‡เธ„เธงเธฒเธกเธฃู้เธ„เธงเธฒเธกเน€เธ‚้เธฒเนƒเธˆ, เธฃเธงเธกเธ—ั้เธ‡เธ เธฒเธงเธฐเธชเธกเธญเธ‡เน€เธชื่เธญเธก. เธœู้เนƒเธซเธ่เธ—ี่เน„เธก่เน„เธ”้เนƒเธŠ้เธ‡เธฒเธ™เธกีเน€เธืเธญเธšเธชเธญเธ‡เน€เธ—่เธฒเธ‚เธญเธ‡เธเธฒเธฃเน€เธชื่เธญเธกเธชเธ เธฒเธžเธ—เธฒเธ‡เธ›ัเธเธเธฒเน€เธ›็เธ™เธœู้เนƒเธซเธ่เธ—ี่เธกีเธเธฒเธฃเนƒเธŠ้เธ‡เธฒเธ™ เธ‚เธญเนเธ™เธฐเธ™ํเธฒเนƒเธซ้เธœู้เนƒเธซเธ่เธช่เธงเธ™เนƒเธซเธ่เธกีเธช่เธงเธ™เธฃ่เธงเธกเนƒเธ™เธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธข 150 เธ™เธฒเธ—ีเธ•่เธญเธชัเธ›เธ”เธฒเธซ์เนƒเธ™เธฃเธฐเธ”ัเธšเธ›เธฒเธ™เธเธฅเธฒเธ‡ เธชิ่เธ‡เธ™ี้เธชเธฒเธกเธฒเธฃเธ–เนเธš่เธ‡เธญเธญเธเน€เธ›็เธ™ 5 เธงัเธ™เธ•่เธญเธชัเธ›เธ”เธฒเธซ์เธ‚เธญเธ‡เน€เธ‹เธชเธŠัเธ™เธฃเธฒเธขเธงัเธ™ 30 เธ™เธฒเธ—ี [6]

เธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธขเธŠ่เธงเธขเธเธฃเธฐเธ•ุ้เธ™เธ„เธงเธฒเธกเน€เธ›็เธ™เธžเธฅเธฒเธชเธ•ิเธเธ‚เธญเธ‡เธชเธกเธญเธ‡เน‚เธ”เธขเธเธฒเธฃเธเธฃเธฐเธ•ุ้เธ™เธเธฒเธฃเน€เธˆเธฃิเธเน€เธ•ิเธšเน‚เธ•เธ‚เธญเธ‡เธเธฒเธฃเน€เธŠื่เธญเธกเธ•่เธญเนƒเธซเธก่เธฃเธฐเธซเธง่เธฒเธ‡เน€เธ‹เธฅเธฅ์เนƒเธ™เธžื้เธ™เธ—ี่เน€เธขื่เธญเธซุ้เธกเธชเธกเธญเธ‡เธ—ี่เธชํเธฒเธ„ัเธเธกเธฒเธเธกเธฒเธขเธ‚เธญเธ‡เธชเธกเธญเธ‡ เธเธฒเธฃเธงิเธˆัเธขเธˆเธฒเธ UCLA เนเธชเธ”เธ‡เนƒเธซ้เน€เธซ็เธ™เธง่เธฒเธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธขเน€เธžิ่เธกเธ›ัเธˆเธˆัเธขเธเธฒเธฃเน€เธˆเธฃิเธเน€เธ•ิเธšเน‚เธ•เนƒเธ™เธชเธกเธญเธ‡เธ—ํเธฒเนƒเธซ้เธชเธกเธญเธ‡เน€เธ•ิเธšเน‚เธ•เธเธฒเธฃเน€เธŠื่เธญเธกเธ•่เธญเธ‚เธญเธ‡เน€เธ‹เธฅเธฅ์เธ›เธฃเธฐเธชเธฒเธ—เนƒเธซเธก่เน„เธ”้เธ‡่เธฒเธขเธ‚ึ้เธ™ [7]

เธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธขเธชเธฒเธกเธฒเธฃเธ–เธžัเธ’เธ™เธฒเธ—ัเธเธฉเธฐเธเธฒเธฃเน€เธฃีเธขเธ™เธฃู้เธฅเธ”เน‚เธญเธเธฒเธชเธ‚เธญเธ‡เธ เธฒเธงเธฐเธชเธกเธญเธ‡เน€เธชื่เธญเธกเนเธฅเธฐเธฅเธ”เธ„เธงเธฒเธกเน€เธชีเธขเธซเธฒเธขเนเธฅเธฐเธเธฒเธฃเน€เธชื่เธญเธกเธชเธ เธฒเธžเธ‚เธญเธ‡เน€เธ™ื้เธญเน€เธขื่เธญเธชเธกเธญเธ‡ เธ™ัเธเธงิเธ—เธขเธฒเธจเธฒเธชเธ•เธฃ์เน€เธŠื่เธญเธง่เธฒเธเธฒเธฃเธฃัเธเธฉเธฒเธชเธกเธฃเธฃเธ–เธ เธฒเธžเธ—เธฒเธ‡เธเธฒเธขเธˆเธฐเธ—ํเธฒเนƒเธซ้เน€เธฅืเธญเธ”เน„เธซเธฅเน€เธงีเธขเธ™เน„เธ›เธขัเธ‡เน€เธ™ื้เธญเน€เธขื่เธญเธชเธกเธญเธ‡เน„เธ”้เธ•เธฒเธกเธ›เธเธ•ิ [8] เน€เธกื่เธญเน€เธฅืเธญเธ”เน„เธซเธฅเธ•เธฒเธกเธ›เธเธ•ิเน„เธ›เธขัเธ‡เน€เธ™ื้เธญเน€เธขื่เธญเธชเธกเธญเธ‡, เธกัเธ™เธŠ่เธงเธขเธฅเธ”เธ„เธงเธฒเธกเน€เธชี่เธขเธ‡เธ‚เธญเธ‡เธ„เธงเธฒเธกเน€เธชีเธขเธซเธฒเธขเนเธฅเธฐเธเธฒเธฃเน€เธชื่เธญเธกเธชเธ เธฒเธž. เธเธฒเธฃเน„เธซเธฅเน€เธงีเธขเธ™เธ‚เธญเธ‡เน€เธฅืเธญเธ”เน€เธ›็เธ™เธชิ่เธ‡เธชํเธฒเธ„ัเธเธกเธฒเธเน€เธกื่เธญเธกัเธ™เธกเธฒเธ–ึเธ‡เธเธฒเธฃเธฃัเธเธฉเธฒเธชเธกเธญเธ‡เธญ่เธญเธ™เน€เธขเธฒเธง์เนเธฅเธฐเธกีเธชุเธ‚เธ เธฒเธžเธ”ี เธ™เธญเธเธˆเธฒเธเธ™ี้เธขัเธ‡เธกีเธเธฒเธฃเธจึเธเธฉเธฒเธ—ี่เนเธชเธ”เธ‡เนƒเธซ้เน€เธซ็เธ™เธง่เธฒเธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธขเนเธšเธšเนเธญเน‚เธฃเธšิเธ„เธŠ่เธงเธขเธเธฃเธฐเธ•ุ้เธ™เธเธฒเธฃเธ›เธฅ่เธญเธขเธฎเธญเธฃ์เน‚เธกเธ™เธเธฒเธฃเน€เธˆเธฃิเธเน€เธ•ิเธšเน‚เธ•เธ‹ึ่เธ‡เธขัเธ‡เธ„เธ‡เธ›เธฃัเธšเธ›เธฃุเธ‡เธเธฒเธฃเธ—ํเธฒเธ‡เธฒเธ™เธ‚เธญเธ‡เธชเธกเธญเธ‡ เน€เธกื่เธญเน€เธ‚้เธฒเธชู่เธงัเธขเธซเธ™ึ่เธ‡เน€เธ›็เธ™เธชิ่เธ‡เธชํเธฒเธ„ัเธเธ—ี่เน€เธฃเธฒเธ•้เธญเธ‡เธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธขเน€เธ›็เธ™เธ›เธฃเธฐเธˆํเธฒเน€เธžื่เธญเนƒเธซ้เธชเธกเธญเธ‡เนเธ‚็เธ‡เนเธฃเธ‡เนเธฅเธฐเธ—ํเธฒเธ‡เธฒเธ™เน„เธ”้เธ”ีเนเธ—เธ™เธ—ี่เธˆเธฐเน€เธชื่เธญเธกเธชเธ เธฒเธž

เน€เธง็เธšเน„เธ‹เธ•์ CDC เธฃเธฐเธšุเธง่เธฒ "เธ—ุเธเธ™ิเธ” เน† เธซเธ™่เธญเธข เน† เธกีเธ„่เธฒ เนเธก้เนเธ•่เธ‡เธฒเธ™เธš้เธฒเธ™เธšเธฒเธ‡เธญเธข่เธฒเธ‡เน€เธŠ่เธ™เธ‡เธฒเธ™เธš้เธฒเธ™เน€เธšเธฒ เน† (เธเธฒเธฃเธเธงเธฒเธ”เนเธฅเธฐเธšเธฃเธฃเธˆุเนƒเธšเน„เธก้เธซเธฃืเธญเนƒเธŠ้เน€เธ„เธฃื่เธญเธ‡เธ•ัเธ”เธซเธ้เธฒ) เนเธฅเธฐเธเธฒเธฃเธ—ํเธฒเธชเธงเธ™เธ็เธชเธฒเธกเธฒเธฃเธ–เธŠ่เธงเธขเนƒเธซ้เธ„ุเธ“เธเธฃเธฐเธ‰ัเธšเธเธฃเธฐเน€เธ‰เธ‡เน„เธ”้"[9]

เธ›เธฃเธฐเน‚เธขเธŠเธ™์เธšเธฒเธ‡เธ›เธฃเธฐเธเธฒเธฃเธ‚เธญเธ‡เธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธขเธ•่เธญเธชุเธ‚เธ เธฒเธžเธชเธกเธญเธ‡เน€เธิเธ”เธ‚ึ้เธ™เธ—ัเธ™เธ—ีเธซเธฅัเธ‡เธˆเธฒเธเธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธขเนƒเธ™เธฃเธฐเธ”ัเธšเธ›เธฒเธ™เธเธฅเธฒเธ‡เธ–ึเธ‡เนเธ‚็เธ‡เนเธฃเธ‡ เธ›เธฃเธฐเน‚เธขเธŠเธ™์เธ—ี่เน„เธ”้เธฃัเธš เน„เธ”้เนเธ่ เธเธฒเธฃเธ›เธฃัเธšเธ›เธฃุเธ‡เธ„เธงเธฒเธกเธ„ิเธ”เธซเธฃืเธญเธ„เธงเธฒเธกเธฃู้เธ„เธงเธฒเธกเน€เธ‚้เธฒเนƒเธˆเธชํเธฒเธซเธฃัเธšเน€เธ”็เธเธญเธฒเธขุ 6-13 เธ›ีเนเธฅเธฐเธฅเธ”เธ„เธงเธฒเธกเธฃู้เธชึเธเธงิเธ•เธเธัเธ‡เธงเธฅเนƒเธ™เธฃเธฐเธขเธฐเธชั้เธ™เธชํเธฒเธซเธฃัเธšเธœู้เนƒเธซเธ่ เธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธขเน€เธ›็เธ™เธ›เธฃเธฐเธˆํเธฒเธชเธฒเธกเธฒเธฃเธ–เธ—ํเธฒเนƒเธซ้เธ—ัเธเธฉเธฐเธเธฒเธฃเธ„ิเธ”เธเธฒเธฃเน€เธฃีเธขเธ™เธฃู้เนเธฅเธฐเธเธฒเธฃเธ•ัเธ”เธชิเธ™เธ„เธกเธŠัเธ”เธ•เธฒเธกเธญเธฒเธขุ เธ™เธญเธเธˆเธฒเธเธ™ี้เธขัเธ‡เธชเธฒเธกเธฒเธฃเธ–เธฅเธ”เธ„เธงเธฒเธกเน€เธชี่เธขเธ‡เธ‚เธญเธ‡เธ เธฒเธงเธฐเธ‹ึเธกเน€เธจเธฃ้เธฒเนเธฅเธฐเธ„เธงเธฒเธกเธงิเธ•เธเธัเธ‡เธงเธฅเนเธฅเธฐเธ›เธฃัเธšเธ›เธฃุเธ‡เธเธฒเธฃเธ™เธญเธ™เธซเธฅัเธš [10]

เธเธฒเธฃเธ„เธงเธšเธ„ุเธกเธ™้ํเธฒเธซเธ™ัเธ

เธ—ั้เธ‡เธญเธฒเธซเธฒเธฃเนเธฅเธฐเธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธขเธกีเธšเธ—เธšเธฒเธ—เธชํเธฒเธ„ัเธเนƒเธ™เธเธฒเธฃเธฃัเธเธฉเธฒเธ™้ํเธฒเธซเธ™ัเธเธ•ัเธงเนƒเธซ้เนเธ‚็เธ‡เนเธฃเธ‡เธฅเธ”เธ™้ํเธฒเธซเธ™ัเธเธ•ัเธงเธช่เธงเธ™เน€เธิเธ™เธซเธฃืเธญเธฃัเธเธฉเธฒเธเธฒเธฃเธฅเธ”เธ™้ํเธฒเธซเธ™ัเธเธ—ี่เธ›เธฃเธฐเธชเธšเธ„เธงเธฒเธกเธชํเธฒเน€เธฃ็เธˆ [11] เธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธขเธŠ่เธงเธขเธ„เธงเธšเธ„ุเธกเธ™้ํเธฒเธซเธ™ัเธเน‚เธ”เธขเนƒเธŠ้เนเธ„เธฅเธญเธฃี่เธช่เธงเธ™เน€เธิเธ™เธ—ี่เธˆเธฐเธ–ูเธเน€เธ็เธšเน„เธง้เน€เธ›็เธ™เน„เธ‚เธกัเธ™ เธญเธฒเธซเธฒเธฃเธช่เธงเธ™เนƒเธซเธ่เธ—ี่เธšเธฃิเน‚เธ เธ„เธกีเนเธ„เธฅเธญเธฃี่เนเธฅเธฐเธิเธˆเธเธฃเธฃเธกเธช่เธงเธ™เนƒเธซเธ่เน€เธœเธฒเธœเธฅเธฒเธเนเธ„เธฅเธญเธฃี่เธฃเธงเธกเธ–ึเธ‡เธเธฒเธฃเธ™เธญเธ™เธซเธฅัเธšเธเธฒเธฃเธซเธฒเธขเนƒเธˆเนเธฅเธฐเธเธฒเธฃเธข่เธญเธขเธญเธฒเธซเธฒเธฃ เธเธฒเธฃเธ›เธฃัเธšเธชเธกเธ”ุเธฅเนเธ„เธฅเธญเธฃี่เธ—ี่เธšเธฃิเน‚เธ เธ„เธัเธšเนเธ„เธฅเธญเธฃี่เธ—ี่เนƒเธŠ้เธœ่เธฒเธ™เธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธขเธชเธฒเธกเธฒเธฃเธ–เธŠ่เธงเธขเนƒเธซ้เนƒเธ„เธฃเธšเธฒเธ‡เธ„เธ™เน€เธ‚้เธฒเธ–ึเธ‡เนเธฅเธฐเธฃัเธเธฉเธฒเธ™้ํเธฒเธซเธ™ัเธเนƒเธซ้เนเธ‚็เธ‡เนเธฃเธ‡เน„เธ”้ [12]

เธเธฅ้เธฒเธกเน€เธ™ื้เธญเธกีเธ„เธงเธฒเธกเธชํเธฒเธ„ัเธเธ•่เธญเธฃ่เธฒเธ‡เธเธฒเธขเธกเธ™ุเธฉเธข์ เธเธฅ้เธฒเธกเน€เธ™ื้เธญเธซเธ™ัเธเธเธง่เธฒเน„เธ‚เธกัเธ™เธ”ัเธ‡เธ™ั้เธ™เน‚เธ”เธขเธเธฒเธฃเธชูเธเน€เธชีเธขเน„เธ‚เธกัเธ™เนเธฅเธฐเน„เธ”้เธฃัเธšเธเธฅ้เธฒเธกเน€เธ™ื้เธญเนƒเธ™เธ›เธฃิเธกเธฒเธ“เธ—ี่เน€เธ—่เธฒเธัเธ™เน€เธฃเธฒเธชเธฒเธกเธฒเธฃเธ–เน€เธžิ่เธกเธ™้ํเธฒเธซเธ™ัเธเน„เธ”้ เธญเธข่เธฒเธ‡เน„เธฃเธ็เธ•เธฒเธกเธฃ่เธฒเธ‡เธเธฒเธขเธญเธฒเธˆเธ”ูเธœเธญเธกเธฅเธ‡เนเธฅเธฐเธœเธญเธกเธฅเธ‡ เธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธขเน„เธก่เน€เธžีเธขเธ‡ เนเธ•่เนƒเธŠ้เธชํเธฒเธซเธฃัเธšเธเธฒเธฃเธฅเธ”เธ™้ํเธฒเธซเธ™ัเธ เนเธ•่เธขัเธ‡เธชํเธฒเธซเธฃัเธšเธเธฒเธฃเน€เธžิ่เธกเธ™้ํเธฒเธซเธ™ัเธ เธ”้เธงเธขเธเธฒเธฃเธกีเธ›เธฃิเธกเธฒเธ“เน‚เธ›เธฃเธ•ีเธ™เธชูเธ‡เน€เธฃเธฒเธชเธฒเธกเธฒเธฃเธ–เธชเธฃ้เธฒเธ‡เธ„เธงเธฒเธกเน€เธ„เธฃีเธขเธ”เนƒเธซ้เธัเธšเน€เธช้เธ™เนƒเธขเธเธฅ้เธฒเธกเน€เธ™ื้เธญเน„เธ”้เน‚เธ”เธขเธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธขเธ—ี่เธˆเธฐเธ—ํเธฒเนƒเธซ้เธžเธงเธเน€เธ‚เธฒเธ‰ีเธเธ‚เธฒเธ” เธ™ี่เธ„ืเธญเน€เธซเธ•ุเธœเธฅเธ—ี่เธซเธ™ึ่เธ‡เธญเธฒเธˆเธฃู้เธชึเธเน€เธˆ็เธš, เน€เธ›็เธ™เน€เธช้เธ™เนƒเธขเธเธฅ้เธฒเธกเน€เธ™ื้เธญเธˆเธฐเน€เธฃิ่เธกเธ•้เธ™เธเธฃเธฐเธšเธงเธ™เธเธฒเธฃเธ‚เธญเธ‡เธเธฒเธฃเธ‰ีเธเธ‚เธฒเธ”เนเธฅเธฐเธเธฒเธฃเธฃัเธเธฉเธฒ. เน€เธกื่เธญเน€เธช้เธ™เนƒเธขเธเธฅ้เธฒเธกเน€เธ™ื้เธญเธซเธฒเธขเธ”ีเธเธฒเธฃเน€เธˆเธฃิเธเน€เธ•ิเธšเน‚เธ•เนเธฅเธฐเธเธฒเธฃเน€เธžิ่เธกเธ™้ํเธฒเธซเธ™ัเธเธˆเธฐเธ›เธฃเธฒเธเธเธ‚ึ้เธ™ เน€เธ™ื่เธญเธ‡เธˆเธฒเธเธกเธงเธฅเธเธฅ้เธฒเธกเน€เธ™ื้เธญเธกีเธ„เธงเธฒเธกเธซเธ™เธฒเนเธ™่เธ™เธกเธฒเธเธเธง่เธฒเธกเธงเธฅเน„เธ‚เธกัเธ™เธเธฒเธฃเน€เธžิ่เธกเธเธฅ้เธฒเธกเน€เธ™ื้เธญเธ•ิเธ”เธกัเธ™เธญเธฒเธˆเธ—ํเธฒเนƒเธซ้เธ™้ํเธฒเธซเธ™ัเธเน€เธžิ่เธกเธ‚ึ้เธ™

เธ›เธฃเธฐเน‚เธขเธŠเธ™์เธฃเธฐเธขเธฐเธขเธฒเธง

เธ„เธงเธฒเธกเน€เธชี่เธขเธ‡เธ•่เธญเธชุเธ‚เธ เธฒเธžเธ—ี่เธžเธšเธกเธฒเธเธ—ี่เธชุเธ” เน„เธ”้เนเธ่ เน‚เธฃเธ„เธซัเธงเนƒเธˆเนเธฅเธฐเธซเธฅเธญเธ”เน€เธฅืเธญเธ”เน‚เธฃเธ„เน€เธšเธฒเธซเธงเธฒเธ™เธŠเธ™ิเธ”เธ—ี่ 2 เนเธฅเธฐเธกเธฐเน€เธฃ็เธ‡เธšเธฒเธ‡เธŠเธ™ิเธ” [11]

เน‚เธฃเธ„เธญ้เธงเธ™เน€เธ›็เธ™เน‚เธฃเธ„เธ—ี่เธ‹ัเธšเธ‹้เธญเธ™เธ—ี่เธกีเธœเธฅเธ•่เธญเธเธฒเธฃเน€เธœเธฒเธœเธฅเธฒเธเธ‚เธญเธ‡เธฃ่เธฒเธ‡เธเธฒเธขเธ—ั้เธ‡เธซเธกเธ”เนเธฅเธฐเน€เธี่เธขเธงเธ‚้เธญเธ‡เธัเธšเธ„เธงเธฒเธกเน€เธชี่เธขเธ‡เธ—ี่เน€เธžิ่เธกเธ‚ึ้เธ™เธ‚เธญเธ‡เน‚เธฃเธ„เธซัเธงเนƒเธˆเนเธฅเธฐเธซเธฅเธญเธ”เน€เธฅืเธญเธ” (CVD) เนเธฅเธฐเน‚เธฃเธ„เน€เธšเธฒเธซเธงเธฒเธ™เธ›เธฃเธฐเน€เธ เธ— 2 (T2D) เธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธขเธช่เธ‡เธœเธฅเนƒเธซ้เน€เธิเธ”เธ›เธฃเธฐเน‚เธขเธŠเธ™์เธ•่เธญเธชุเธ‚เธ เธฒเธžเธกเธฒเธเธกเธฒเธขเนเธฅเธฐเน€เธ›็เธ™เน€เธ„เธฃื่เธญเธ‡เธกืเธญเธชํเธฒเธ„ัเธเนƒเธ™เธเธฒเธฃเธ•่เธญเธชู้เธัเธšเน‚เธฃเธ„เธญ้เธงเธ™เนเธฅเธฐเธเธฒเธฃเน€เธˆ็เธšเธ›่เธงเธขเธฃ่เธงเธกเธฃเธงเธกเธ–ึเธ‡เน‚เธฃเธ„เธซัเธงเนƒเธˆเนเธฅเธฐเธซเธฅเธญเธ”เน€เธฅืเธญเธ” เธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธขเธŠ่เธงเธขเธ›้เธญเธ‡เธัเธ™เธ—ั้เธ‡เธเธฒเธฃเน‚เธˆเธกเธ•ีเนเธฅเธฐเธเธฒเธฃเธžัเธ’เธ™เธฒเธ‚เธญเธ‡เน‚เธฃเธ„เธซัเธงเนƒเธˆเนเธฅเธฐเธซเธฅเธญเธ”เน€เธฅืเธญเธ”เนเธฅเธฐเน€เธ›็เธ™เน€เธ„เธฃื่เธญเธ‡เธกืเธญเนƒเธ™เธเธฒเธฃเธฃัเธเธฉเธฒเธ—ี่เธชํเธฒเธ„ัเธเนƒเธ™เธเธฒเธฃเธ›เธฃัเธšเธ›เธฃุเธ‡เธœเธฅเธฅัเธžเธ˜์เธชํเธฒเธซเธฃัเธšเธœู้เธ›่เธงเธขเน‚เธฃเธ„เธซัเธงเนƒเธˆเนเธฅเธฐเธซเธฅเธญเธ”เน€เธฅืเธญเธ” เธ›เธฃเธฐเน‚เธขเธŠเธ™์เธšเธฒเธ‡เธ›เธฃเธฐเธเธฒเธฃเธ‚เธญเธ‡เธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธข เน„เธ”้เนเธ่ เธเธฒเธฃเธ—ํเธฒเธ‡เธฒเธ™เธ‚เธญเธ‡เน„เธกเน‚เธ•เธ„เธญเธ™เน€เธ”เธฃีเธขเธ—ี่เน€เธžิ่เธกเธ‚ึ้เธ™เธเธฒเธฃเธŸื้เธ™เธŸูเนเธฅเธฐเธ›เธฃัเธšเธ›เธฃุเธ‡ vasculature เนเธฅเธฐเธเธฒเธฃเธ›เธฅ่เธญเธข myokines เธˆเธฒเธเธเธฅ้เธฒเธกเน€เธ™ื้เธญเน‚เธ„เธฃเธ‡เธฃ่เธฒเธ‡เธ—ี่เธฃัเธเธฉเธฒเธซเธฃืเธญเน€เธžิ่เธกเธเธฒเธฃเธ—ํเธฒเธ‡เธฒเธ™เธ‚เธญเธ‡เธซัเธงเนƒเธˆเนเธฅเธฐเธซเธฅเธญเธ”เน€เธฅืเธญเธ” เนƒเธ™เธเธฒเธฃเธ•เธฃเธงเธˆเธชเธญเธšเธ™ี้เน€เธฃเธฒเธˆเธฐเธžูเธ”เธ–ึเธ‡เธเธฅเน„เธเธ—ี่เธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธขเธช่เธ‡เน€เธชเธฃิเธกเธชุเธ‚เธ เธฒเธžเธซัเธงเนƒเธˆเนเธฅเธฐเธซเธฅเธญเธ”เน€เธฅืเธญเธ” เธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธขเน€เธ›็เธ™เธ›เธฃเธฐเธˆํเธฒเธกีเธœเธฅเธ”ีเธ•่เธญเธชุเธ‚เธ เธฒเธžเน‚เธ”เธขเธฃเธงเธกเธซเธฅเธฒเธขเธ›เธฃเธฐเธเธฒเธฃ เนเธก้เธง่เธฒเธเธฒเธฃเธฅเธ”เธฅเธ‡เธ‚เธญเธ‡เธกเธงเธฅเธเธฒเธขเนเธฅเธฐเน„เธ‚เธกัเธ™เธˆเธฐเน„เธก่เนƒเธŠ่เธœเธฅเธฅัเธžเธ˜์เธซเธฅัเธเธ‚เธญเธ‡เธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธข เนเธ•่เธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธขเธชเธฒเธกเธฒเธฃเธ–เน„เธเธฅ่เน€เธเธฅี่เธขเน‚เธฃเธ„เธ•่เธฒเธ‡เน† เธ—ี่เธกเธฒเธžเธฃ้เธญเธกเธัเธšเน‚เธฃเธ„เธญ้เธงเธ™ เธฃเธงเธกเธ–ึเธ‡ T2D เนเธฅเธฐ CVD เธเธฒเธฃเธจึเธเธฉเธฒเธฅ่เธฒเธชุเธ”เธซเธฅเธฒเธขเธŠิ้เธ™เนเธชเธ”เธ‡เนƒเธซ้เน€เธซ็เธ™เธง่เธฒเธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธขเธญเธข่เธฒเธ‡เธ•่เธญเน€เธ™ื่เธญเธ‡เธกีเธ„เธงเธฒเธกเธชัเธกเธžัเธ™เธ˜์เธัเธšเน€เธ„เธฃื่เธญเธ‡เธซเธกเธฒเธขเธ‚เธญเธ‡เธเธฒเธฃเธญัเธเน€เธชเธšเธ—ี่เธฅเธ”เธฅเธ‡เธชุเธ‚เธ เธฒเธžเธเธฒเธฃเน€เธœเธฒเธœเธฅเธฒเธเธ—ี่เธ”ีเธ‚ึ้เธ™เธฅเธ”เธ„เธงเธฒเธกเน€เธชี่เธขเธ‡เธ‚เธญเธ‡เธ เธฒเธงเธฐเธซัเธงเนƒเธˆเธฅ้เธกเน€เธซเธฅเธงเนเธฅเธฐเธเธฒเธฃเธญเธขู่เธฃเธญเธ”เน‚เธ”เธขเธฃเธงเธกเธ—ี่เธ”ีเธ‚ึ้เธ™ [13][14][15]เธกีเธ›ัเธˆเธˆัเธขเน€เธชี่เธขเธ‡เธซเธฅเธฒเธขเธ›เธฃเธฐเธเธฒเธฃเธ—ี่เธ™ํเธฒเน„เธ›เธชู่เธเธฒเธฃเธžัเธ’เธ™เธฒเนเธฅเธฐเธ„เธงเธฒเธกเธ้เธฒเธงเธซเธ™้เธฒเธ‚เธญเธ‡ CVD เนเธ•่เธซเธ™ึ่เธ‡เนƒเธ™เธชิ่เธ‡เธ—ี่เน‚เธ”เธ”เน€เธ”่เธ™เธ—ี่เธชุเธ”เธ„ืเธญเธเธฒเธฃเนƒเธŠ้เธŠีเธงิเธ•เธญเธขู่เธ›เธฃเธฐเธˆํเธฒ เธเธฒเธฃเนƒเธŠ้เธŠีเธงิเธ•เธญเธขู่เธ›เธฃเธฐเธˆํเธฒเธชเธฒเธกเธฒเธฃเธ–เน‚เธ”เธ”เน€เธ”่เธ™เธ”้เธงเธขเน‚เธฃเธ„เธญ้เธงเธ™เนเธฅเธฐเธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธขเนƒเธ™เธฃเธฐเธ”ัเธšเธ•่ํเธฒเธญเธข่เธฒเธ‡เธ•่เธญเน€เธ™ื่เธญเธ‡ เธ”ัเธ‡เธ™ั้เธ™เธเธฒเธฃเนเธ—เธฃเธเนเธ‹เธ‡เธงิเธ–ีเธŠีเธงิเธ•เธ—ี่เธกีเธˆุเธ”เธกุ่เธ‡เธซเธกเธฒเธขเน€เธžื่เธญเน€เธžิ่เธกเธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธขเนเธฅเธฐเธฅเธ”เน‚เธฃเธ„เธญ้เธงเธ™เธˆึเธ‡เน€เธ›็เธ™เธงิเธ˜ีเธเธฒเธฃเธฃัเธเธฉเธฒเธ—ี่เธ™่เธฒเธชเธ™เนƒเธˆเน€เธžื่เธญเธ•่เธญเธชู้เธัเธš CVD เธ›เธฃเธฐเน€เธ เธ—เธ—ี่เน„เธก่เธกีเธกเธฒ เนเธ•่เธํเธฒเน€เธ™ิเธ”เธช่เธงเธ™เนƒเธซเธ่ [16]

เธ›ัเธˆเธˆัเธขเน€เธชี่เธขเธ‡เน‚เธฃเธ„เธซัเธงเนƒเธˆเนเธฅเธฐเธซเธฅเธญเธ”เน€เธฅืเธญเธ”

เธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธขเน€เธ›็เธ™เธ›เธฃเธฐเธˆํเธฒเน€เธี่เธขเธงเธ‚้เธญเธ‡เธัเธšเธ›เธฃเธฐเน‚เธขเธŠเธ™์เธ•่เธญเธชุเธ‚เธ เธฒเธžเธกเธฒเธเธกเธฒเธขเน€เธžื่เธญเธฅเธ”เธเธฒเธฃเธฅุเธเธฅเธฒเธกเนเธฅเธฐเธเธฒเธฃเธžัเธ’เธ™เธฒเธ‚เธญเธ‡เน‚เธฃเธ„เธญ้เธงเธ™ T2D เนเธฅเธฐ CVD เธเธฒเธฃเธ—เธ”เธฅเธญเธ‡เธ—เธฒเธ‡เธ„เธฅิเธ™ิเธเนเธšเธšเธชุ่เธกเธซเธฅเธฒเธขเธ„เธฃั้เธ‡เนเธชเธ”เธ‡เนƒเธซ้เน€เธซ็เธ™เธง่เธฒเธงิเธ˜ีเธเธฒเธฃเนƒเธ™เธเธฒเธฃเธ”ํเธฒเน€เธ™ิเธ™เธŠีเธงิเธ•เธฃเธงเธกเธ–ึเธ‡เธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธขเนƒเธ™เธฃเธฐเธ”ัเธšเธ›เธฒเธ™เธเธฅเธฒเธ‡เนเธฅเธฐเธเธฒเธฃเธฃัเธšเธ›เธฃเธฐเธ—เธฒเธ™เธญเธฒเธซเธฒเธฃเน€เธžื่เธญเธชุเธ‚เธ เธฒเธžเธŠ่เธงเธขเธ›เธฃัเธšเธ›เธฃุเธ‡เธชุเธ‚เธ เธฒเธžเธซัเธงเนƒเธˆเนเธฅเธฐเธซเธฅเธญเธ”เน€เธฅืเธญเธ”เนƒเธ™เธ›เธฃเธฐเธŠเธฒเธเธฃเธ—ี่เธกีเธ„เธงเธฒเธกเน€เธชี่เธขเธ‡ เธšุเธ„เธ„เธฅเธ—ี่เธกีเธญเธฒเธเธฒเธฃเน€เธกเธ•เธฒเธšเธญเธฅิเธ‹ึเธกเธ—ี่เน€เธ‚้เธฒเธฃ่เธงเธกเนƒเธ™เน‚เธ›เธฃเนเธเธฃเธก 4 เน€เธ”ืเธญเธ™เธ‚เธญเธ‡เธญเธฒเธซเธฒเธฃ (เธ‚้เธญ เธˆํเธฒเธัเธ” เนเธ„เธฅเธญเธฃี่) เธซเธฃืเธญเธเธฒเธฃเนเธ—เธฃเธเนเธ‹เธ‡เธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธขเธกี adiposity เธฅเธ”เธฅเธ‡, เธฅเธ”เธ„เธงเธฒเธกเธ”ัเธ™เน‚เธฅเธซิเธ•เธ‹ิเธชเน‚เธ•เธฅิเธ, diastolic เนเธฅเธฐเธ„่เธฒเน€เธ‰เธฅี่เธขเนเธฅเธฐเน„เธฅเน‚เธ›เน‚เธ›เธฃเธ•ีเธ™เธฃเธงเธกเนเธฅเธฐเธ„เธงเธฒเธกเธซเธ™เธฒเนเธ™่เธ™เธ•่ํเธฒ (LDL) เน‚เธ›เธฃเน„เธŸเธฅ์เน„เธ‚เธกัเธ™เธ„เธญเน€เธฅเธชเน€เธ•เธญเธฃเธญเธฅเน€เธกื่เธญเน€เธ—ีเธขเธšเธัเธšเธเธฅุ่เธกเธ„เธงเธšเธ„ุเธก เธเธฒเธฃเนเธ—เธฃเธเนเธ‹เธ‡เธ—ั้เธ‡เธญเธฒเธซเธฒเธฃเนเธฅเธฐเธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธขเธŠ่เธงเธขเธ›เธฃัเธšเธ›เธฃุเธ‡เธœเธฅเธฅัเธžเธ˜์เธ‚เธญเธ‡เธซัเธงเนƒเธˆเนเธฅเธฐเธซเธฅเธญเธ”เน€เธฅืเธญเธ”เน€เธซเธฅ่เธฒเธ™ี้เนƒเธ™เธฃเธฐเธ”ัเธšเธ—ี่เนƒเธเธฅ้เน€เธ„ีเธขเธ‡เธัเธ™ [17]

เธเธฒเธฃเธจึเธเธฉเธฒเธ่เธญเธ™เธซเธ™้เธฒเธ™ี้เธซเธฅเธฒเธขเธŠิ้เธ™เน„เธ”้เธ•เธฃเธงเธˆเธชเธญเธšเธœเธฅเธ‚เธญเธ‡เธเธฒเธฃเธฃัเธšเธ›เธฃเธฐเธ—เธฒเธ™เธญเธฒเธซเธฒเธฃเนเธฅเธฐเธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธขเธญเธข่เธฒเธ‡เธญิเธชเธฃเธฐเธซเธฃืเธญเธฃเธงเธกเธัเธ™เธ•่เธญเธเธฒเธฃเน€เธœเธฒเธœเธฅเธฒเธเนเธฅเธฐเธชุเธ‚เธ เธฒเธžเธซัเธงเนƒเธˆเนเธฅเธฐเธซเธฅเธญเธ”เน€เธฅืเธญเธ”เนเธฅเธฐเน„เธ”้เธžิเธˆเธฒเธฃเธ“เธฒเนเธฅ้เธงเธง่เธฒเธญเธฒเธซเธฒเธฃเธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธขเธซเธฃืเธญเธเธฒเธฃเธฃเธงเธกเธัเธ™เธ‚เธญเธ‡เธญเธฒเธซเธฒเธฃเนเธฅเธฐเธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธขเธ—ํเธฒเนƒเธซ้เน€เธิเธ”เธเธฒเธฃเธฅเธ”เธ™้ํเธฒเธซเธ™ัเธเธฅเธ”เธ„เธงเธฒเธกเธญ้เธงเธ™เนƒเธ™เธญเธงัเธขเธงเธฐเธ เธฒเธขเนƒเธ™เธฅเธ”เน„เธ•เธฃเธเธฅีเน€เธ‹เธญเน„เธฃเธ”์เนƒเธ™เธžเธฅเธฒเธชเธกเธฒเธฃเธฐเธ”ัเธšเธ™้ํเธฒเธ•เธฒเธฅเนƒเธ™เน€เธฅืเธญเธ”เธฃเธฐเธ”ัเธš HDL เนเธฅเธฐเธ„เธงเธฒเธกเธ”ัเธ™เน‚เธฅเธซิเธ•เนเธฅเธฐเธ›เธฃัเธšเธ›เธฃุเธ‡ VO2max เธ—ี่เธชํเธฒเธ„ัเธ, เธซเธฅเธฒเธขเธœเธฅเธ›เธฃเธฐเน‚เธขเธŠเธ™์เน€เธซเธฅ่เธฒเธ™ี้เธ‚เธญเธ‡เธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธขเธˆเธฐเน€เธซ็เธ™เน„เธ”้เธŠัเธ”เน€เธ›็เธ™เธญิเธชเธฃเธฐเธˆเธฒเธเธเธฒเธฃเธฅเธ”เธ™้ํเธฒเธซเธ™ัเธ. เธเธฒเธฃเธจึเธเธฉเธฒเนเธชเธ”เธ‡เนƒเธซ้เน€เธซ็เธ™เธง่เธฒเธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธขเธชเธฒเธกเธฒเธฃเธ–เธ›เธฃัเธšเธ›เธฃุเธ‡เธเธฒเธฃเน€เธœเธฒเธœเธฅเธฒเธเนเธฅเธฐเธชุเธ‚เธ เธฒเธžเธซัเธงเนƒเธˆเนเธฅเธฐเธซเธฅเธญเธ”เน€เธฅืเธญเธ”เน‚เธ”เธขเน„เธก่เธ‚ึ้เธ™เธัเธšเธเธฒเธฃเน€เธ›เธฅี่เธขเธ™เนเธ›เธฅเธ‡เธ‚เธญเธ‡เธ™้ํเธฒเธซเธ™ัเธเธ•ัเธงเธฃเธงเธกเธ–ึเธ‡เธชเธ เธฒเธงเธฐเธชเธกเธ”ุเธฅเธ‚เธญเธ‡เธเธฅูเน‚เธ„เธชเธ—ี่เธ”ีเธ‚ึ้เธ™เธเธฒเธฃเธ—ํเธฒเธ‡เธฒเธ™เธ‚เธญเธ‡เน€เธขื่เธญเธšุเธœเธ™ัเธ‡เธซเธฅเธญเธ”เน€เธฅืเธญเธ”เธ„เธงเธฒเธกเธ”ัเธ™เน‚เธฅเธซิเธ•เนเธฅเธฐเธฃเธฐเธ”ัเธš HDL เธ‚้เธญเธกูเธฅเน€เธซเธฅ่เธฒเธ™ี้เธš่เธ‡เธšเธญเธเธ–ึเธ‡เธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธขเน‚เธ”เธขเน„เธก่เธ‚ึ้เธ™เธัเธšเธเธฒเธฃเน€เธ›เธฅี่เธขเธ™เนเธ›เธฅเธ‡เธ‚เธญเธ‡เธกเธงเธฅเธเธฒเธขเธช่เธ‡เธœเธฅเนƒเธซ้เธชุเธ‚เธ เธฒเธžเธซัเธงเนƒเธˆเนเธฅเธฐเธซเธฅเธญเธ”เน€เธฅืเธญเธ”เนเธฅเธฐเธเธฒเธฃเน€เธœเธฒเธœเธฅเธฒเธเธ”ีเธ‚ึ้เธ™เธญเธข่เธฒเธ‡เธกีเธ™ัเธขเธชํเธฒเธ„ัเธ เนเธก้เธง่เธฒเธเธฒเธฃเธงิเน€เธ„เธฃเธฒเธฐเธซ์เน‚เธ”เธขเธฅเธฐเน€เธญีเธขเธ”เน€เธี่เธขเธงเธัเธšเธœเธฅเธเธฃเธฐเธ—เธšเธกเธฒเธเธกเธฒเธขเธ‚เธญเธ‡เธญเธฒเธซเธฒเธฃเธ•่เธญเธชุเธ‚เธ เธฒเธž cardiometabolic เธญเธขู่เธ™เธญเธเธ‚เธญเธšเน€เธ‚เธ•เธ‚เธญเธ‡เธเธฒเธฃเธ—เธšเธ—เธงเธ™เธงเธฃเธฃเธ“เธเธฃเธฃเธกเธ™ี้ เนเธ•่เน„เธก่เธ„เธงเธฃเธฅเธฐเน€เธฅเธขเธ„เธงเธฒเธกเธชํเธฒเธ„ัเธเธ‚เธญเธ‡เธเธฒเธฃเธฃัเธšเธ›เธฃเธฐเธ—เธฒเธ™เธญเธฒเธซเธฒเธฃเนเธฅเธฐเธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธขเธ„เธงเธšเธ„ู่เธัเธ™เน„เธ› เน€เธ™ื่เธญเธ‡เธˆเธฒเธเธเธฒเธฃเธจึเธเธฉเธฒเธˆํเธฒเธ™เธงเธ™เธกเธฒเธเนเธชเธ”เธ‡เนƒเธซ้เน€เธซ็เธ™เธง่เธฒเธชุเธ‚เธ เธฒเธž cardiometabolic เธ”ีเธ‚ึ้เธ™เนƒเธ™เธฃเธฐเธ”ัเธšเธ—ี่เธชูเธ‡เธ‚ึ้เธ™เนƒเธ™เธเธฒเธฃเธ•เธญเธšเธชเธ™เธญเธ‡เธ•่เธญเน‚เธ›เธฃเนเธเธฃเธกเธ„เธงเธšเธ„ุเธกเธญเธฒเธซเธฒเธฃเนเธฅเธฐเธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธขเนเธšเธšเธฃเธงเธกเน€เธกื่เธญเน€เธ—ีเธขเธšเธัเธšเธเธฒเธฃเนเธ—เธฃเธเนเธ‹เธ‡เน€เธžีเธขเธ‡เธญเธข่เธฒเธ‡เน€เธ”ีเธขเธง [17]

เธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธขเธกีเธœเธฅเธ„เธฅ้เธฒเธขเธัเธ™เธ•่เธญเธเธฒเธฃเธ›เธฃัเธšเธ›เธฃุเธ‡เธซัเธงเนƒเธˆเนเธฅเธฐเธซเธฅเธญเธ”เน€เธฅืเธญเธ”เนƒเธ™เธงิเธŠเธฒ normoglycemic เนเธšเธšเธฅีเธ™เนเธฅเธฐเธ™้ํเธฒเธซเธ™ัเธเน€เธิเธ™ เนƒเธ™เธเธฒเธฃเธจึเธเธฉเธฒ 1 เธ›ีเธ‚เธญเธ‡เธšุเธ„เธ„เธฅเธ—ี่เน„เธก่เน„เธ”้เน€เธ›็เธ™เน‚เธฃเธ„เธญ้เธงเธ™เธ„่เธฒเนƒเธŠ้เธˆ่เธฒเธขเธžเธฅัเธ‡เธ‡เธฒเธ™เน€เธžิ่เธกเธ‚ึ้เธ™ 16-20% (เธ‚เธญเธ‡เธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธขเธ—ุเธเธฃูเธ›เนเธšเธš) เน‚เธ”เธขเน„เธก่เธกีเธเธฒเธฃเนเธ—เธฃเธเนเธ‹เธ‡เธญเธฒเธซเธฒเธฃเธช่เธ‡เธœเธฅเนƒเธซ้เธกเธงเธฅเน„เธ‚เธกัเธ™เนƒเธ™เธฃ่เธฒเธ‡เธเธฒเธขเธฅเธ”เธฅเธ‡ 22.3% เนเธฅเธฐเธฅเธ”เธ„เธญเน€เธฅเธชเน€เธ•เธญเธฃเธญเธฅ LDL เธญัเธ•เธฃเธฒเธช่เธงเธ™เธ„เธญเน€เธฅเธชเน€เธ•เธญเธฃเธญเธฅเธฃเธงเธก / HDL เนเธฅเธฐเธ„เธงเธฒเธกเน€เธ‚้เธกเธ‚้เธ™เธ‚เธญเธ‡เน‚เธ›เธฃเธ•ีเธ™ C-reactive เธ›ัเธˆเธˆัเธขเน€เธชี่เธขเธ‡เธ—ั้เธ‡เธซเธกเธ”เธ—ี่เน€เธี่เธขเธงเธ‚้เธญเธ‡เธัเธš CVD เนƒเธ™เธœู้เธ—ี่เธกีเธ™้ํเธฒเธซเธ™ัเธเน€เธิเธ™เธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธขเธ—ี่เธกีเธ„เธงเธฒเธกเน€เธ‚้เธกเธ‚้เธ™เธ•่ํเธฒ 7-9 เน€เธ”ืเธญเธ™ (เน€เธ”ิเธ™ ~ 19 เธเธก. เธ•่เธญเธชัเธ›เธ”เธฒเธซ์เธ—ี่ 40-55% VO2peak) เน€เธžิ่เธกเธชเธกเธฃเธฃเธ–เธ เธฒเธžเธซัเธงเนƒเธˆเนเธฅเธฐเธซเธฅเธญเธ”เน€เธฅืเธญเธ”เธญเธข่เธฒเธ‡เธกีเธ™ัเธขเธชํเธฒเธ„ัเธเน€เธกื่เธญเน€เธ—ีเธขเธšเธัเธšเธšุเธ„เธ„เธฅเธ—ี่เธญเธขู่เธ›เธฃเธฐเธˆํเธฒ เธ‚้เธญเธกูเธฅเน€เธซเธฅ่เธฒเธ™ี้เธฃ่เธงเธกเธัเธ™เธš่เธ‡เธŠี้เธง่เธฒเธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธขเธŠ่เธงเธขเธฅเธ”เธ„เธงเธฒเธกเน€เธชี่เธขเธ‡เธ‚เธญเธ‡เธซเธฃืเธญเธ„เธงเธฒเธกเธฃุเธ™เนเธฃเธ‡เธ‚เธญเธ‡ CVD เนƒเธ™เธญเธฒเธชเธฒเธชเธกัเธ„เธฃเธ—ี่เน„เธก่เธ•ิเธ”เธกัเธ™ เธญ้เธงเธ™ เธซเธฃืเธญเน€เธ›็เธ™เน‚เธฃเธ„เน€เธšเธฒเธซเธงเธฒเธ™เธ›เธฃเธฐเน€เธ เธ— 2 [17]

เธเธฒเธฃเธŸื้เธ™เธŸูเธชเธกเธฃเธฃเธ–เธ เธฒเธžเธซัเธงเนƒเธˆ

เธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธขเธขัเธ‡เน€เธ›็เธ™เธเธฒเธฃเธฃัเธเธฉเธฒเธ—ี่เธชํเธฒเธ„ัเธเธชํเธฒเธซเธฃัเธšเธœู้เธ›่เธงเธขเธ—ี่เน€เธ›็เธ™เน‚เธฃเธ„เธซัเธงเนƒเธˆเนเธฅเธฐเธซเธฅเธญเธ”เน€เธฅืเธญเธ” เธเธฒเธฃเธ—เธšเธ—เธงเธ™เธญเธข่เธฒเธ‡เน€เธ›็เธ™เธฃเธฐเธšเธšเธˆเธฒเธเธเธฒเธฃเธจึเธเธฉเธฒ 63 เธฃเธฒเธขเธเธฒเธฃเธžเธšเธง่เธฒเธเธฒเธฃเธŸื้เธ™เธŸูเธซัเธงเนƒเธˆเน‚เธ”เธขเนƒเธŠ้เธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธขเธŠ่เธงเธขเธ›เธฃัเธšเธ›เธฃุเธ‡เธเธฒเธฃเธ—ํเธฒเธ‡เธฒเธ™เธ‚เธญเธ‡เธซัเธงเนƒเธˆเนเธฅเธฐเธซเธฅเธญเธ”เน€เธฅืเธญเธ” เธเธฒเธฃเธจึเธเธฉเธฒเน€เธซเธฅ่เธฒเธ™ี้เธ›เธฃเธฐเธเธญเธšเธ”้เธงเธขเธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธขเนเธšเธšเนเธญเน‚เธฃเธšิเธ„เนƒเธ™เธฃูเธ›เนเธšเธšเธ•่เธฒเธ‡เน† เธ—ี่เธŠ่เธงเธ‡เธ„เธงเธฒเธกเน€เธ‚้เธก (เธ•ั้เธ‡เนเธ•่ 50 เธ–ึเธ‡ 95% VO2) เนƒเธ™เธŠ่เธงเธ‡เน€เธงเธฅเธฒเธ•่เธฒเธ‡เน† (1–47 เน€เธ”ืเธญเธ™) เน‚เธ”เธขเธฃเธงเธกเนเธฅ้เธงเธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธขเธŠ่เธงเธขเธฅเธ”เธเธฒเธฃเน€เธชีเธขเธŠีเธงิเธ•เธ—ี่เน€เธี่เธขเธงเธ‚้เธญเธ‡เธัเธš CVD เธฅเธ”เธ„เธงเธฒเธกเน€เธชี่เธขเธ‡เธ‚เธญเธ‡ MI เนเธฅเธฐเธ„ุเธ“เธ เธฒเธžเธŠีเธงิเธ•เธ—ี่เธ”ีเธ‚ึ้เธ™ เธเธฒเธฃเธจึเธเธฉเธฒเธญื่เธ™เธ”ูเน‚เธ”เธขเน€เธ‰เธžเธฒเธฐเนƒเธ™เธœู้เธ›่เธงเธขเธ—ี่เธกีเธเธฒเธฃเธœ่เธฒเธ•ัเธ”เธซเธฅเธญเธ”เน€เธฅืเธญเธ”เธซเธฅัเธ‡เธเธฒเธฃเธŸื้เธ™เธŸู เธœู้เธ›่เธงเธขเธ—ี่เธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธข 60 เธ™เธฒเธ—ีเธ•่เธญเธงัเธ™เธ”้เธงเธข ergometer เธฃเธญเธšเน€เธ›็เธ™เน€เธงเธฅเธฒ 4 เธชัเธ›เธ”เธฒเธซ์เธกีเธเธฒเธฃเน„เธซเธฅเน€เธงีเธขเธ™เธ‚เธญเธ‡เน€เธฅืเธญเธ”เน€เธžิ่เธกเธ‚ึ้เธ™ (29%) เนเธฅเธฐเธ›เธฃัเธšเธ›เธฃุเธ‡เธเธฒเธฃเธ‚เธขเธฒเธขเธซเธฅเธญเธ”เน€เธฅืเธญเธ”เธ—ี่เธ‚ึ้เธ™เธัเธš endothelium เธเธฒเธฃเธจึเธเธฉเธฒเธฅ่เธฒเธชุเธ”เนƒเธซ้เน‚เธ›เธฃเนเธเธฃเธกเธเธฒเธฃเธŸื้เธ™เธŸูเธชเธกเธฃเธฃเธ–เธ เธฒเธžเธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธขเนเธšเธšเนเธญเน‚เธฃเธšิเธ„เธช่เธงเธ™เธšุเธ„เธ„เธฅเธชํเธฒเธซเธฃัเธšเธœู้เธ›่เธงเธขเธ—ี่เธกีเธเธฅ้เธฒเธกเน€เธ™ื้เธญเธซัเธงเนƒเธˆเธ•เธฒเธขเน€เธ‰ีเธขเธšเธžเธฅัเธ™เน€เธ›็เธ™เน€เธงเธฅเธฒ 1 เธ›ีเธซเธฅัเธ‡เธˆเธฒเธเธเธฒเธฃเธœ่เธฒเธ•ัเธ”เธซเธฅเธญเธ”เน€เธฅืเธญเธ”เธซัเธงเนƒเธˆ เธœู้เธ›่เธงเธขเธ—ี่เน€เธ‚้เธฒเธฃัเธšเธเธฒเธฃเธŸื้เธ™เธŸูเธชเธกเธฃเธฃเธ–เธ เธฒเธžเธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธขเน„เธ”้เน€เธžิ่เธกเธชัเธ”เธช่เธงเธ™เธเธฒเธฃเธ‚ัเธšเธญเธญเธ (เธเธฅุ่เธกเธ„เธงเธšเธ„ุเธก 60.81 เน€เธ—ีเธขเธšเธัเธš 53%) เน€เธžิ่เธกเธ„เธงเธฒเธกเธ—เธ™เธ—เธฒเธ™เธ•่เธญเธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธขเนเธฅเธฐเธฅเธ”เธ›ัเธˆเธˆัเธขเน€เธชี่เธขเธ‡เน‚เธฃเธ„เธซัเธงเนƒเธˆเนเธฅเธฐเธซเธฅเธญเธ”เน€เธฅืเธญเธ” 6 เน€เธ”ืเธญเธ™เธซเธฅัเธ‡เธˆเธฒเธเน€เธฃิ่เธกเน‚เธ›เธฃเนเธเธฃเธกเธเธฒเธฃเธŸื้เธ™เธŸูเธชเธกเธฃเธฃเธ–เธ เธฒเธžเธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธข เธเธฒเธฃเธ›เธฃัเธšเธ›เธฃุเธ‡เธชุเธ‚เธ เธฒเธžเธซัเธงเนƒเธˆเนเธฅเธฐเธซเธฅเธญเธ”เน€เธฅืเธญเธ”เนƒเธ™เธœู้เธ›่เธงเธขเธ—ี่เธกีเธซเธฅเธญเธ”เน€เธฅืเธญเธ”เธซเธฃืเธญเธซเธฅัเธ‡ MI เธ™่เธฒเธˆเธฐเน€เธ›็เธ™เธœเธฅเธกเธฒเธˆเธฒเธเธเธฒเธฃเน„เธซเธฅเน€เธงีเธขเธ™เธ‚เธญเธ‡เธเธฅ้เธฒเธกเน€เธ™ื้เธญเธซัเธงเนƒเธˆเธ•เธฒเธขเธ—ี่เน€เธžิ่เธกเธ‚ึ้เธ™เนƒเธ™เธเธฒเธฃเธ•เธญเธšเธชเธ™เธญเธ‡เธ•่เธญเธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธขเธญเธข่เธฒเธ‡เน„เธฃเธ็เธ•เธฒเธกเธˆํเธฒเน€เธ›็เธ™เธ•้เธญเธ‡เธกีเธเธฒเธฃเธงิเธˆัเธขเน€เธžิ่เธกเน€เธ•ิเธกเน€เธžื่เธญเธ—ํเธฒเธ„เธงเธฒเธกเน€เธ‚้เธฒเนƒเธˆเธเธฅเน„เธเน€เธซเธฅ่เธฒเธ™ี้เธญเธข่เธฒเธ‡เธ–่เธญเธ‡เนเธ—้ [18]

เธฅัเธเธฉเธ“เธฐเธซเธ™ึ่เธ‡เธ—ี่เธํเธฒเธซเธ™เธ”เธ‚เธญเธ‡เธ เธฒเธงเธฐเธซัเธงเนƒเธˆเธฅ้เธกเน€เธซเธฅเธงเธ„ืเธญเธเธฒเธฃเนเธž้เธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธขเธ‹ึ่เธ‡เธช่เธ‡เธœเธฅเนƒเธซ้เธกีเนƒเธšเธชั่เธ‡เธขเธฒเธžัเธเน€เธ•ีเธขเธ‡เธชํเธฒเธซเธฃัเธšเธœู้เธ›่เธงเธขเน€เธซเธฅ่เธฒเธ™ี้เธˆเธ™เธ–ึเธ‡เธ›ี 1950 เธญเธข่เธฒเธ‡เน„เธฃเธ็เธ•เธฒเธกเธ•เธญเธ™เธ™ี้เน„เธ”้เนเธชเธ”เธ‡เนƒเธซ้เน€เธซ็เธ™เธง่เธฒเน‚เธ›เธฃเนเธเธฃเธกเธเธฒเธฃเธŸื้เธ™เธŸูเธชเธกเธฃเธฃเธ–เธ เธฒเธžเธ—ี่เน„เธ”้เธฃัเธšเธเธฒเธฃเธ•เธฃเธงเธˆเธชเธญเธšเน‚เธ”เธขเนƒเธŠ้เธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธขเธ—ี่เธกีเธ„เธงเธฒเธกเน€เธ‚้เธกเธ‚้เธ™เธ›เธฒเธ™เธเธฅเธฒเธ‡เธ™ั้เธ™เธ›เธฅเธญเธ”เธ ัเธขเธชํเธฒเธซเธฃัเธšเธœู้เธ›่เธงเธขเธซัเธงเนƒเธˆเธฅ้เธกเน€เธซเธฅเธงเนเธฅเธฐเธ•เธญเธ™เธ™ี้เน„เธ”้เธเธฅเธฒเธขเน€เธ›็เธ™เธงิเธ˜ีเธเธฒเธฃเธฃัเธเธฉเธฒเธ—ี่เธชํเธฒเธ„ัเธเธชํเธฒเธซเธฃัเธšเธœู้เธ›่เธงเธขเธ—ี่เธกีเธ เธฒเธงเธฐเธซัเธงเนƒเธˆเธฅ้เธกเน€เธซเธฅเธง เธเธฒเธฃเธงิเน€เธ„เธฃเธฒเธฐเธซ์เธญเธ ิเธกเธฒเธ™เนเธฅเธฐเธเธฒเธฃเธ—เธšเธ—เธงเธ™เธงเธฃเธฃเธ“เธเธฃเธฃเธกเธญเธข่เธฒเธ‡เน€เธ›็เธ™เธฃเธฐเธšเธšเนเธชเธ”เธ‡เนƒเธซ้เน€เธซ็เธ™เธง่เธฒเธเธฒเธฃเธึเธเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธขเนƒเธ™เธœู้เธ›่เธงเธขเธ เธฒเธงเธฐเธซัเธงเนƒเธˆเธฅ้เธกเน€เธซเธฅเธงเธกีเธ„เธงเธฒเธกเธชัเธกเธžัเธ™เธ˜์เธัเธšเธ„ุเธ“เธ เธฒเธžเธŠีเธงิเธ•เธ—ี่เธ”ีเธ‚ึ้เธ™เธฅเธ”เธ„เธงเธฒเธกเน€เธชี่เธขเธ‡เธ‚เธญเธ‡เธเธฒเธฃเน€เธ‚้เธฒเธฃัเธšเธเธฒเธฃเธฃัเธเธฉเธฒเนƒเธ™เน‚เธฃเธ‡เธžเธขเธฒเธšเธฒเธฅเนเธฅเธฐเธญัเธ•เธฃเธฒเธเธฒเธฃเน€เธชีเธขเธŠีเธงิเธ•เนƒเธ™เธฃเธฐเธขเธฐเธขเธฒเธงเธฅเธ”เธฅเธ‡ เธเธฒเธฃเธจึเธเธฉเธฒเธซเธ™ึ่เธ‡เธ‚เธญเธ‡เธœู้เธ›่เธงเธขเธ เธฒเธงเธฐเธซัเธงเนƒเธˆเธฅ้เธกเน€เธซเธฅเธงเธžเธšเธง่เธฒเธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธขเนเธšเธšเนเธญเน‚เธฃเธšิเธ„ (เธเธฒเธฃเน€เธ”ิเธ™เธซเธฃืเธญเธเธฒเธฃเธ‚ี่เธˆัเธเธฃเธขเธฒเธ™) เธ—ี่ 60-70% เธ‚เธญเธ‡เธญัเธ•เธฃเธฒเธเธฒเธฃเน€เธ•้เธ™เธ‚เธญเธ‡เธซัเธงเนƒเธˆเธชํเธฒเธฃเธญเธ‡ 3-5 เธ„เธฃั้เธ‡เธ•่เธญเธชัเธ›เธ”เธฒเธซ์เธกเธฒเธ™เธฒเธ™เธเธง่เธฒ 3 เธ›ีเธ™ํเธฒเน„เธ›เธชู่เธชุเธ‚เธ เธฒเธžเธ—ี่เธ”ีเธ‚ึ้เธ™เนเธฅเธฐเธ„ุเธ“เธ เธฒเธžเธŠีเธงิเธ•เน‚เธ”เธขเธฃเธงเธก (เธํเธฒเธซเธ™เธ”เน‚เธ”เธขเนเธšเธšเธชเธญเธšเธ–เธฒเธก Kansas City Cardiomyopathy เธ—ี่เธฃเธฒเธขเธ‡เธฒเธ™เธ”้เธงเธขเธ•เธ™เน€เธญเธ‡เนเธšเธšเธชเธญเธšเธ–เธฒเธกเน€เธ‰เธžเธฒเธฐเน‚เธฃเธ„ 23 เธ„ํเธฒเธ–เธฒเธก) เธเธฒเธฃเธจึเธเธฉเธฒเธญื่เธ™ เน† เนเธชเธ”เธ‡เนƒเธซ้เน€เธซ็เธ™เธง่เธฒเธเธฒเธฃเธŸื้เธ™เธŸูเธชเธกเธฃเธฃเธ–เธ เธฒเธžเน‚เธ”เธขเนƒเธŠ้เธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธขเนƒเธ™เธฃเธฐเธ”ัเธšเธ›เธฒเธ™เธเธฅเธฒเธ‡เนƒเธ™เธœู้เธ›่เธงเธขเธ เธฒเธงเธฐเธซัเธงเนƒเธˆเธฅ้เธกเน€เธซเธฅเธงเธŠ่เธงเธขเน€เธžิ่เธกเธชเธกเธฃเธฃเธ–เธ เธฒเธžเธ—เธฒเธ‡เธซัเธงเนƒเธˆเนเธฅเธฐเธซเธฅเธญเธ”เน€เธฅืเธญเธ”เนเธฅเธฐเน€เธžิ่เธกเธ„เธงเธฒเธกเธชเธฒเธกเธฒเธฃเธ–เนƒเธ™เธเธฒเธฃเธญเธ”เธ—เธ™เนƒเธ™เธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธขเนเธฅเธฐ VO2max (เน€เธžิ่เธกเธ‚ึ้เธ™ 12-31%) [18]

เธเธฒเธฃเธจึเธเธฉเธฒเธฅ่เธฒเธชุเธ”เน„เธ”้เธ•เธฃเธงเธˆเธชเธญเธšเธœเธฅเธ‚เธญเธ‡เธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธขเธ—ี่เธกีเธ„เธงเธฒเธกเน€เธ‚้เธกเธ‚้เธ™เธชูเธ‡เธ•่เธญเธœู้เธ›่เธงเธขเธ—ี่เธกีเธ เธฒเธงเธฐเธซัเธงเนƒเธˆเธฅ้เธกเน€เธซเธฅเธง เธเธฒเธฃเธจึเธเธฉเธฒเธฅ่เธฒเธชุเธ”เธžเธšเธง่เธฒ 12 เธชัเธ›เธ”เธฒเธซ์เธ‚เธญเธ‡เธเธฒเธฃเธึเธเธŠ่เธงเธ‡เธ„เธงเธฒเธกเน€เธ‚้เธกเธชูเธ‡ (HIIT) เนƒเธ™เธœู้เธ›่เธงเธขเธ เธฒเธงเธฐเธซัเธงเนƒเธˆเธฅ้เธกเน€เธซเธฅเธง (เธ—ี่เธกีเน€เธจเธฉเธช่เธงเธ™เธเธฒเธฃเธ‚ัเธšเธญเธญเธเธฅเธ”เธฅเธ‡) เธ™ั้เธ™เธ—เธ™เน„เธ”้เธ”ีเนเธฅเธฐเธกีเธ›เธฃเธฐเน‚เธขเธŠเธ™์เธ—ี่เธ„เธฅ้เธฒเธขเธ„เธฅึเธ‡เธัเธ™เน€เธกื่เธญเน€เธ—ีเธขเธšเธัเธšเธœู้เธ›่เธงเธขเธ—ี่เน„เธ”้เธฃัเธšเธเธฒเธฃเธึเธเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธขเธ•่เธญเน€เธ™ื่เธญเธ‡เนƒเธ™เธฃเธฐเธ”ัเธšเธ›เธฒเธ™เธเธฅเธฒเธ‡ (MCE) เธฃเธงเธกเธ–ึเธ‡เธเธฒเธฃเธ›เธฃัเธšเธ›เธฃุเธ‡เธเธฒเธฃเน€เธ›เธฅี่เธขเธ™เนเธ›เธฅเธ‡เธ‚เธญเธ‡เธเธฃเธฐเน€เธ›๋เธฒเธซเธ™้เธฒเธ—้เธญเธ‡เธ”้เธฒเธ™เธ‹้เธฒเธขเนเธฅเธฐเธ„เธงเธฒเธกเธชเธฒเธกเธฒเธฃเธ–เนƒเธ™เธเธฒเธฃเน€เธ•้เธ™เนเธญเน‚เธฃเธšิเธ เธเธฒเธฃเธจึเธเธฉเธฒเนเธขเธเธ•่เธฒเธ‡เธซเธฒเธเธžเธšเธง่เธฒ 4 เธชัเธ›เธ”เธฒเธซ์เธ‚เธญเธ‡ HIIT เนƒเธ™เธœู้เธ›่เธงเธขเธ เธฒเธงเธฐเธซัเธงเนƒเธˆเธฅ้เธกเน€เธซเธฅเธงเธ—ี่เธกีเน€เธจเธฉเธช่เธงเธ™เธเธฒเธฃเธ‚ัเธšเธญเธญเธเธ—ี่เน€เธ็เธšเธฃัเธเธฉเธฒเน„เธง้เธŠ่เธงเธขเธ›เธฃัเธšเธ›เธฃุเธ‡ VO2peak เนเธฅเธฐเธฅเธ”เธ„เธงเธฒเธกเธœิเธ”เธ›เธเธ•ิเธ‚เธญเธ‡ diastolic เน€เธกื่เธญเน€เธ—ีเธขเธšเธัเธšเธ—ั้เธ‡เธ„่เธฒเธ่เธญเธ™เธเธฒเธฃเธึเธเธญเธšเธฃเธกเนเธฅเธฐเน€เธกื่เธญเน€เธ—ีเธขเธšเธัเธšเธเธฅุ่เธก MCE เธเธฒเธฃเธจึเธเธฉเธฒเน€เธซเธฅ่เธฒเธ™ี้เธš่เธ‡เธŠี้เธง่เธฒเธเธฒเธฃเธึเธเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธขเธ—ั้เธ‡เนƒเธ™เธฃเธฐเธ”ัเธšเธ›เธฒเธ™เธเธฅเธฒเธ‡เนเธฅเธฐเธฃเธฐเธ”ัเธšเธชูเธ‡เธŠ่เธงเธขเธ›เธฃัเธšเธ›เธฃุเธ‡เธเธฒเธฃเธ—ํเธฒเธ‡เธฒเธ™เธ‚เธญเธ‡เธซัเธงเนƒเธˆเนเธฅเธฐเธซเธฅเธญเธ”เน€เธฅืเธญเธ”เนƒเธ™เธœู้เธ›่เธงเธขเธ เธฒเธงเธฐเธซัเธงเนƒเธˆเธฅ้เธกเน€เธซเธฅเธงเธ‹ึ่เธ‡เธ™่เธฒเธˆเธฐเน€เธี่เธขเธงเธ‚้เธญเธ‡เธัเธšเธเธฒเธฃเธ‚เธขเธฒเธขเธซเธฅเธญเธ”เน€เธฅืเธญเธ”เธ—ี่เธ‚ึ้เธ™เธัเธš endothelium เธ—ี่เน€เธžิ่เธกเธ‚ึ้เธ™เนเธฅเธฐเธ„เธงเธฒเธกเธชเธฒเธกเธฒเธฃเธ–เนƒเธ™เธเธฒเธฃเน€เธ•้เธ™เนเธญเน‚เธฃเธšิเธเธ—ี่เธ”ีเธ‚ึ้เธ™ [18]

เธ›เธฃเธฐเน‚เธขเธŠเธ™์เธญื่เธ™เน†

เธเธฃเธฐเธ”ูเธเนเธฅเธฐเธเธฅ้เธฒเธกเน€เธ™ื้เธญ

เธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธขเน€เธ›็เธ™เธ›เธฃเธฐเธˆํเธฒเน€เธ›็เธ™เธชิ่เธ‡เธชํเธฒเธ„ัเธเธชํเธฒเธซเธฃัเธšเธเธฒเธฃเธชเธฃ้เธฒเธ‡เธเธฃเธฐเธ”ูเธเนเธฅเธฐเธเธฅ้เธฒเธกเน€เธ™ื้เธญเธ—ี่เนเธ‚็เธ‡เนเธฃเธ‡เนƒเธ™เน€เธ”็เธ เนเธ•่เธ็เธกีเธ„เธงเธฒเธกเธชํเธฒเธ„ัเธเน€เธ—่เธฒเน€เธ—ีเธขเธกเธัเธ™เธัเธšเธœู้เธชูเธ‡เธญเธฒเธขุ เธเธฃเธฐเธ”ูเธเนเธฅเธฐเธเธฅ้เธฒเธกเน€เธ™ื้เธญเธ—ํเธฒเธ‡เธฒเธ™เธฃ่เธงเธกเธัเธ™เน€เธžื่เธญเธชเธ™ัเธšเธชเธ™ุเธ™เธเธฒเธฃเน€เธ„เธฅื่เธญเธ™เน„เธซเธงเธ›เธฃเธฐเธˆํเธฒเธงัเธ™ เธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธขเน€เธชเธฃิเธกเธชเธฃ้เธฒเธ‡เธเธฅ้เธฒเธกเน€เธ™ื้เธญ เธเธฃเธฐเธ”ูเธเธ›เธฃัเธšเธ•ัเธงเน‚เธ”เธขเธเธฒเธฃเธชเธฃ้เธฒเธ‡เน€เธ‹เธฅเธฅ์เธกเธฒเธเธ‚ึ้เธ™เนเธฅเธฐเน€เธ›็เธ™เธœเธฅเนƒเธซ้เธ—ั้เธ‡เธชเธญเธ‡เนเธ‚็เธ‡เนเธฃเธ‡เธ‚ึ้เธ™ เธเธฃเธฐเธ”ูเธเนเธฅเธฐเธเธฅ้เธฒเธกเน€เธ™ื้เธญเธ—ี่เนเธ‚็เธ‡เนเธฃเธ‡เธŠ่เธงเธขเธ›้เธญเธ‡เธัเธ™เธเธฒเธฃเธšเธฒเธ”เน€เธˆ็เธšเนเธฅเธฐเธ›เธฃัเธšเธ›เธฃุเธ‡เธ„เธงเธฒเธกเธชเธกเธ”ุเธฅเนเธฅเธฐเธเธฒเธฃเธ›เธฃเธฐเธชเธฒเธ™เธ‡เธฒเธ™ เธ™เธญเธเธˆเธฒเธเธ™ี้เธœู้เนƒเธซเธ่เธ—ี่เธเธฃเธฐเธ•ืเธญเธฃืเธญเธฃ้เธ™เธˆเธฐเธกีเธญเธฒเธเธฒเธฃเธ•ึเธ‡เธ‚เธญเธ‡เธ‚้เธญเธ•่เธญเธ™้เธญเธขเธฅเธ‡เนเธฅเธฐเธ„เธงเธฒเธกเธขืเธ”เธซเธขุ่เธ™เธ—ี่เธ”ีเธ‚ึ้เธ™ เธชิ่เธ‡เธ™ี้เธกีเธ„เธงเธฒเธกเธชํเธฒเธ„ัเธเธญเธข่เธฒเธ‡เธขิ่เธ‡เน€เธกื่เธญเธญเธฒเธขุเธกเธฒเธเธ‚ึ้เธ™เน€เธ™ื่เธญเธ‡เธˆเธฒเธเธŠ่เธงเธขเธ›้เธญเธ‡เธัเธ™เธเธฒเธฃเธซเธเธฅ้เธกเนเธฅเธฐเธเธฃเธฐเธ”ูเธเธซัเธเธ—ี่เธญเธฒเธˆเน€เธิเธ”เธ‚ึ้เธ™เน„เธ”้ เธชํเธฒเธซเธฃัเธšเธœู้เธ—ี่เน€เธ›็เธ™เน‚เธฃเธ„เธ‚้เธญเธญัเธเน€เธชเธšเธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธขเธ—ี่เธŠ่เธงเธขเนƒเธซ้เธเธฅ้เธฒเธกเน€เธ™ื้เธญเธฃเธญเธš เน† เธ‚้เธญเธ•่เธญเนเธ‚็เธ‡เนเธฃเธ‡เธชเธฒเธกเธฒเธฃเธ–เธ—ํเธฒเธซเธ™้เธฒเธ—ี่เน€เธซเธกืเธญเธ™เธฃั้เธ‡เธ—ี่เธˆเธฐเธ•เธญเธšเธชเธ™เธญเธ‡เธ•่เธญเธเธฒเธฃเน€เธ„เธฅื่เธญเธ™เน„เธซเธงเน‚เธ”เธขเน„เธก่เธ•้เธญเธ‡เนƒเธŠ้เน€เธ„เธฃื่เธญเธ‡เธกืเธญเธˆัเธ”เธŸัเธ™เธˆเธฃิเธ‡ [19]

เธิเธˆเธเธฃเธฃเธกเธ›เธฃเธฐเธˆํเธฒเธงัเธ™

เธ„เธงเธฒเธกเธชเธฒเธกเธฒเธฃเธ–เนƒเธ™เธเธฒเธฃเธ—ํเธฒเธิเธˆเธเธฃเธฃเธกเธ›เธฃเธฐเธˆํเธฒเธงัเธ™เนเธฅเธฐเธฃัเธเธฉเธฒเธ„เธงเธฒเธกเน€เธ›็เธ™เธญิเธชเธฃเธฐเธ•้เธญเธ‡เนƒเธŠ้เธเธฅ้เธฒเธกเน€เธ™ื้เธญเนเธ‚็เธ‡เนเธฃเธ‡เธชเธกเธ”ุเธฅเนเธฅเธฐเธ„เธงเธฒเธกเธญเธ”เธ—เธ™ เธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธขเธซเธฃืเธญเธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธขเน€เธ›็เธ™เธ›เธฃเธฐเธˆํเธฒเธˆเธฐเธŠ่เธงเธขเธ›เธฃัเธšเธ›เธฃุเธ‡เนเธฅเธฐเธ›้เธญเธ‡เธัเธ™เธเธฒเธฃเธฅเธ”เธฅเธ‡เธ‚เธญเธ‡เธ„เธงเธฒเธกเนเธ‚็เธ‡เนเธฃเธ‡เธ‚เธญเธ‡เธเธฅ้เธฒเธกเน€เธ™ื้เธญเธ„เธงเธฒเธกเธชเธกเธ”ุเธฅเนเธฅเธฐเธ„เธงเธฒเธกเธญเธ”เธ—เธ™เธ›ัเธˆเธˆัเธขเน€เธชี่เธขเธ‡เธ—ั้เธ‡เธซเธกเธ”เธชํเธฒเธซเธฃัเธšเธเธฒเธฃเธฅ้เธก เธเธฒเธฃเธ—เธฃเธ‡เธ•ัเธงเธกีเธšเธ—เธšเธฒเธ—เธชํเธฒเธ„ัเธเนƒเธ™เธิเธˆเธเธฃเธฃเธกเธ›เธฃเธฐเธˆํเธฒเธงัเธ™ เน€เธŠ่เธ™ เธเธฒเธฃเน€เธ”ิเธ™ เธเธฒเธฃเธฅุเธเธ‚ึ้เธ™เธˆเธฒเธเน€เธ้เธฒเธญี้ เธซเธฃืเธญเธเธฒเธฃเน€เธญเธ™เธ•ัเธงเน€เธžื่เธญเธซเธขิเธšเธญเธฐเน„เธฃเธšเธฒเธ‡เธญเธข่เธฒเธ‡เธ‚ึ้เธ™เธกเธฒ เธ›ัเธเธซเธฒเธ„เธงเธฒเธกเธชเธกเธ”ุเธฅเธชเธฒเธกเธฒเธฃเธ–เธฅเธ”เธ„เธงเธฒเธกเน€เธ›็เธ™เธญิเธชเธฃเธฐเน‚เธ”เธขเธฃเธšเธเธงเธ™เธิเธˆเธเธฃเธฃเธกเนƒเธ™เธŠีเธงิเธ•เธ›เธฃเธฐเธˆํเธฒเธงัเธ™ เธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธขเน€เธ›็เธ™เธ›เธฃเธฐเธˆํเธฒเธชเธฒเธกเธฒเธฃเธ–เธ›เธฃัเธšเธ›เธฃุเธ‡เธ„เธงเธฒเธกเธชเธกเธ”ุเธฅเนเธฅเธฐเธฅเธ”เธ„เธงเธฒเธกเน€เธชี่เธขเธ‡เธ‚เธญเธ‡เธเธฒเธฃเธฅ้เธก [20]

เธกเธฐเน€เธฃ็เธ‡

เธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธขเน€เธžิ่เธกเน‚เธญเธเธฒเธชเนƒเธ™เธเธฒเธฃเธฃเธญเธ”เธŠีเธงิเธ•เธˆเธฒเธเน‚เธฃเธ„เธกเธฐเน€เธฃ็เธ‡ เธซเธฒเธเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธขเนƒเธ™เธฃเธฐเธขเธฐเนเธฃเธเธ‚เธญเธ‡เธเธฒเธฃเธฃัเธเธฉเธฒเธกเธฐเน€เธฃ็เธ‡ เธญเธฒเธˆเนƒเธซ้เน€เธงเธฅเธฒเนƒเธ™เธเธฒเธฃเธฅเธ”เธœเธฅเธ‚้เธฒเธ‡เน€เธ„ีเธขเธ‡เธ—ี่เน€เธ›็เธ™เธญัเธ™เธ•เธฃเธฒเธขเธ‚เธญเธ‡เน€เธ„เธกีเธšํเธฒเธšัเธ” เธ™เธญเธเธˆเธฒเธเธ™ี้เธขัเธ‡เธŠ่เธงเธขเธ›เธฃัเธšเธ›เธฃุเธ‡เธเธฒเธฃเธ—ํเธฒเธ‡เธฒเธ™เธ—เธฒเธ‡เธเธฒเธขเธ เธฒเธžเธžเธฃ้เธญเธกเธัเธšเธฅเธ”เธ„เธงเธฒเธกเธ—ุเธเธ‚์เนเธฅเธฐเธ„เธงเธฒเธกเน€เธซเธ™ื่เธญเธขเธฅ้เธฒ [21] เธเธฒเธฃเธจึเธเธฉเธฒเนเธชเธ”เธ‡เนƒเธซ้เน€เธซ็เธ™เธง่เธฒเธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธขเธกีเธ„เธงเธฒเธกเน€เธ›็เธ™เน„เธ›เน„เธ”้เธ—ี่เธˆเธฐเธ›เธฃัเธšเธ›เธฃุเธ‡เธเธฒเธฃเธ”ูเธ”เธ‹ึเธกเธขเธฒเน€เธ„เธกีเธšํเธฒเธšัเธ”เน€เธ™ื่เธญเธ‡เธˆเธฒเธเธเธฒเธฃเน€เธžิ่เธกเธ‚ึ้เธ™เธ‚เธญเธ‡เธเธฒเธฃเน„เธซเธฅเน€เธงีเธขเธ™เธ‚เธญเธ‡เธญุเธ›เธเธฃเธ“์เธ•่เธญเธž่เธงเธ‡ [21] เธ™เธญเธเธˆเธฒเธเธ™ี้เธขัเธ‡เธ—ํเธฒเนƒเธซ้เธเธฒเธฃเน€เธ›เธฅี่เธขเธ™เนเธ›เธฅเธ‡เน€เธ™ื้เธญเธ‡เธญเธ vasculature เธˆเธฒเธเธเธฒเธฃเน€เธžิ่เธกเธ‚ึ้เธ™เธ‚เธญเธ‡เธซัเธงเนƒเธˆเนเธฅเธฐเธ„เธงเธฒเธกเธ”ัเธ™เน‚เธฅเธซิเธ•

เธเธฒเธฃเธ™เธญเธ™เธซเธฅัเธš

เธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธขเธ—ํเธฒเนƒเธซ้เธญุเธ“เธซเธ ูเธกิเธ‚เธญเธ‡เธฃ่เธฒเธ‡เธเธฒเธขเน€เธžิ่เธกเธ‚ึ้เธ™เนเธฅเธฐเธญุเธ“เธซเธ ูเธกิเธ—ี่เธฅเธ”เธฅเธ‡เธซเธฅัเธ‡เธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธขเธญเธฒเธˆเธ—ํเธฒเนƒเธซ้เธซเธฅัเธšเน„เธ”้ เธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธขเธญเธฒเธˆเธฅเธ”เธญเธฒเธเธฒเธฃเธ™เธญเธ™เน„เธก่เธซเธฅัเธšเน‚เธ”เธขเธฅเธ”เธญเธฒเธเธฒเธฃเน€เธฃ้เธฒเธญเธฒเธฃเธกเธ“์เธ„เธงเธฒเธกเธงิเธ•เธเธัเธ‡เธงเธฅเนเธฅเธฐเธญเธฒเธเธฒเธฃเธ‹ึเธกเน€เธจเธฃ้เธฒ เธเธฒเธฃเธ™เธญเธ™เน„เธก่เธซเธฅัเธšเธกัเธเน€เธŠื่เธญเธกเน‚เธขเธ‡เธัเธšเธ„เธงเธฒเธกเธ•ื่เธ™เธ•ัเธงเธ„เธงเธฒเธกเธงิเธ•เธเธัเธ‡เธงเธฅเนเธฅเธฐเธ เธฒเธงเธฐเธ‹ึเธกเน€เธจเธฃ้เธฒเธ—ี่เน€เธžิ่เธกเธ‚ึ้เธ™เนเธฅเธฐเธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธขเธกีเธœเธฅเธ•่เธญเธเธฒเธฃเธฅเธ”เธญเธฒเธเธฒเธฃเน€เธซเธฅ่เธฒเธ™ี้เนƒเธ™เธ›เธฃเธฐเธŠเธฒเธเธฃเธ—ั่เธงเน„เธ› [22] เธ›ัเธเธซเธฒเน€เธซเธฅ่เธฒเธ™ี้เธ™ัเธšเน€เธ›็เธ™เธซเธ™ึ่เธ‡เนƒเธ™เธ›ัเธเธซเธฒเธ—ี่เธžเธšเธš่เธญเธขเธ—ี่เธชุเธ”เนƒเธ™เธซเธกู่เธ›เธฃเธฐเธŠเธฒเธเธฃเธช่เธงเธ™เนƒเธซเธ่ เน‚เธฃเธ„เธงิเธ•เธเธัเธ‡เธงเธฅเน€เธ›็เธ™เน‚เธฃเธ„เธ—เธฒเธ‡เธˆิเธ•เธ—ี่เธžเธšเธš่เธญเธขเธ—ี่เธชุเธ”เนƒเธ™เธชเธซเธฃัเธเธญเน€เธกเธฃิเธเธฒเธ‹ึ่เธ‡เธช่เธ‡เธœเธฅเธเธฃเธฐเธ—เธšเธ•่เธญเธœู้เนƒเธซเธ่ 40 เธฅ้เธฒเธ™เธ„เธ™เนƒเธ™เธชเธซเธฃัเธเธญเน€เธกเธฃิเธเธฒเธ—ี่เธกีเธญเธฒเธขุ 18 เธ›ีเธ‚ึ้เธ™เน„เธ›เธซเธฃืเธญ 18.1% เธ‚เธญเธ‡เธ›เธฃเธฐเธŠเธฒเธเธฃเธ—ุเธเธ›ี [23] เธเธฒเธฃเธ—เธšเธ—เธงเธ™เธงเธฃเธฃเธ“เธเธฃเธฃเธกเนƒเธ™เธ›ี 2010 เธŠี้เนƒเธซ้เน€เธซ็เธ™เธง่เธฒเธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธขเน‚เธ”เธขเธ—ั่เธงเน„เธ›เธŠ่เธงเธขเน€เธžิ่เธกเธเธฒเธฃเธ™เธญเธ™เธซเธฅัเธšเธชํเธฒเธซเธฃัเธšเธ„เธ™เธช่เธงเธ™เนƒเธซเธ่เนเธฅเธฐเธญเธฒเธˆเธŠ่เธงเธขเนƒเธซ้เธ™เธญเธ™เน„เธก่เธซเธฅัเธš เนเธ•่เธกีเธซเธฅัเธเธเธฒเธ™เน„เธก่เน€เธžีเธขเธ‡เธžเธญเธ—ี่เธˆเธฐเธชเธฃุเธ›เธฃเธฒเธขเธฅเธฐเน€เธญีเธขเธ”เน€เธี่เธขเธงเธัเธšเธ„เธงเธฒเธกเธชัเธกเธžัเธ™เธ˜์เธฃเธฐเธซเธง่เธฒเธ‡เธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธขเนเธฅเธฐเธเธฒเธฃเธ™เธญเธ™เธซเธฅัเธš เธเธฒเธฃเธ—เธšเธ—เธงเธ™เธงเธฃเธฃเธ“เธเธฃเธฃเธกเธญเธข่เธฒเธ‡เน€เธ›็เธ™เธฃเธฐเธšเธšเนเธฅเธฐเธเธฒเธฃเธงิเน€เธ„เธฃเธฒเธฐเธซ์เน€เธกเธ•เธฒเธ”เธฒเธ•้เธฒเนƒเธ™เธ›ี 2020 เธŠี้เนƒเธซ้เน€เธซ็เธ™เธง่เธฒเธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธขเธกีเธ„เธงเธฒเธกเธชัเธกเธžัเธ™เธ˜์เน€เธžีเธขเธ‡เน€เธฅ็เธเธ™้เธญเธขเธัเธšเธเธฒเธฃเธ™เธญเธ™เธซเธฅัเธšเนƒเธ™เน€เธ”็เธเธ—ี่เธกีเธชุเธ‚เธ เธฒเธžเธ”ี [26] เธญเธข่เธฒเธ‡เน„เธฃเธ็เธ•เธฒเธกเธกีเธœเธฅเธเธฒเธฃเธงิเธˆัเธขเธซเธฅเธฒเธขเธŠิ้เธ™เธ—ี่เธฃเธฐเธšุเธง่เธฒเธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธขเธšเธฒเธ‡เธฃูเธ›เนเธšเธšเธชเธฒเธกเธฒเธฃเธ–เธ›เธฃัเธšเธ›เธฃุเธ‡เธ„ุเธ“เธ เธฒเธžเนเธฅเธฐเธฃเธฐเธขเธฐเน€เธงเธฅเธฒเธเธฒเธฃเธ™เธญเธ™เธซเธฅัเธšเน„เธ”้ [27] เนƒเธ™เธ„เธงเธฒเธกเน€เธ›็เธ™เธˆเธฃิเธ‡เธเธฒเธฃเธจึเธเธฉเธฒเนƒเธ™เธ›ี 2019 เธ—ี่เธกเธซเธฒเธงิเธ—เธขเธฒเธฅัเธขเนเธซ่เธ‡เธชเธซเธžัเธ™เธ˜เธฃัเธเน€เธ‹เธฒเน€เธ›เธฒเน‚เธฅเธชเธฃุเธ›เธง่เธฒเธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธขเนƒเธ™เธฃเธฐเธ”ัเธšเธ›เธฒเธ™เธเธฅเธฒเธ‡เธช่เธ‡เธœเธฅเนƒเธซ้เธ›เธฃเธฐเธชิเธ—เธ˜ิเธ เธฒเธžเธเธฒเธฃเธ™เธญเธ™เธซเธฅัเธšเนเธฅเธฐเธฃเธฐเธขเธฐเน€เธงเธฅเธฒเน€เธžิ่เธกเธ‚ึ้เธ™เนƒเธ™เธœู้เนƒเธซเธ่เธ—ี่เน„เธ”้เธฃัเธšเธเธฒเธฃเธงิเธ™ิเธˆเธ‰ัเธขเธง่เธฒเน€เธ›็เธ™เน‚เธฃเธ„เธ™เธญเธ™เน„เธก่เธซเธฅัเธš [28] เธฃเธฐเธขเธฐเน€เธงเธฅเธฒเธซเธกเธฒเธขเธ–ึเธ‡เธŠั่เธงเน‚เธกเธ‡เธเธฒเธฃเธ™เธญเธ™เธซเธฅัเธšเธ—ี่เธšุเธ„เธ„เธฅเน„เธ”้เธฃัเธšเน€เธ›็เธ™เธ›เธฃเธฐเธˆํเธฒเธ—ุเธเธ„ืเธ™เนƒเธ™เธ‚เธ“เธฐเธ—ี่เธ„ุเธ“เธ เธฒเธžเธš่เธ‡เธŠี้เธง่เธฒเธกัเธ™เธ”ีเธซเธฃืเธญเน€เธžีเธขเธ‡เธžเธญเน€เธžีเธขเธ‡เนƒเธ” [29] เธเธฒเธฃเธกีเธ„ุเธ“เธ เธฒเธžเธเธฒเธฃเธ™เธญเธ™เธซเธฅัเธšเธ—ี่เน„เธก่เธ”ีเธญเธฒเธˆเธ™ํเธฒเน„เธ›เธชู่เธœเธฅเธเธฃเธฐเธ—เธšเธฃเธฐเธขเธฐเธชั้เธ™เน€เธŠิเธ‡เธฅเธšเน€เธŠ่เธ™เธ„เธงเธฒเธกเธ—ุเธเธ‚์เธ—เธฒเธ‡เธญเธฒเธฃเธกเธ“์เนเธฅเธฐเธเธฒเธฃเธ‚เธฒเธ”เธ”ุเธฅเธ›เธฃเธฐเธชิเธ—เธ˜ิเธ เธฒเธž เธ›ัเธเธซเธฒเธ—เธฒเธ‡เธˆิเธ•เธชัเธ‡เธ„เธกเธ—ี่เน€เธี่เธขเธงเธ‚้เธญเธ‡เธัเธšเธœเธฅเธเธฃเธฐเธ—เธšเน€เธซเธฅ่เธฒเธ™ี้เธญเธฒเธˆเนเธ•เธเธ•่เธฒเธ‡เธัเธ™เน„เธ›เธฃเธฐเธซเธง่เธฒเธ‡เธœู้เนƒเธซเธ่เธงัเธขเธฃุ่เธ™เนเธฅเธฐเน€เธ”็เธ เธšเธฒเธ‡เธช่เธงเธ™เธ‚เธญเธ‡เธœเธฅเธเธฃเธฐเธ—เธšเธฃเธฐเธขเธฐเธขเธฒเธงเธ‚เธญเธ‡เธ„ุเธ“เธ เธฒเธžเธเธฒเธฃเธ™เธญเธ™เธซเธฅัเธšเธ—ี่เน„เธก่เธ”ีเธชเธฒเธกเธฒเธฃเธ–เธ™ํเธฒเน„เธ›เธชู่เน€เธ‡ื่เธญเธ™เน„เธ‚เน€เธŠ่เธ™เธ„เธงเธฒเธกเธ”ัเธ™เน‚เธฅเธซิเธ•เธชูเธ‡, เน‚เธฃเธ„เน€เธกเธ•เธฒเธšเธญเธฅิเธ‹ึเธก, เนเธฅเธฐเนเธก้เธเธฃเธฐเธ—ั่เธ‡เธ›ัเธเธซเธฒเธ—ี่เน€เธี่เธขเธงเธ‚้เธญเธ‡เธัเธšเธ™้ํเธฒเธซเธ™ัเธ. [30]

เธ›เธฃเธฐเน‚เธขเธŠเธ™์เธ‚เธญเธ‡เธเธฒเธฃเธญเธญเธเธํเธฒเธฅัเธ‡เธเธฒเธข - เธงิเธิเธžีเน€เธ”ีเธข (wikipedia.org)

Share on Google Plus

About ❤️JeffSinee❤️

SFBKK.com, a website about all things good and beautiful, including healthy living, healthy food, wonderous nature, travel, beautiful islands, music, great beaches/resorts and calming spirituality from God, Jesus, and Buddha. Love to all.

0 Comments :

Post a Comment