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«“√ “√ √“™∫— ≥±‘ µ¬ ∂“π ªï ∑’Ë ÛÒ ©∫— ∫∑’Ë Ò ¡.§.-¡’ .§. ÚıÙ˘ ¬ß§å «‘ ¡≈ ‡≈≥∫ÿ √’ ·≈–™π¡å ∑‘ µ“ √— µπ°ÿ ≈ 53 „π√Ÿ ª∑’Ë Ú ∆Τ = 21 «— π ·≈– p = 28 «— π ‡√“®–‡ÀÁ π«à “‰¡à ¡’ °“√ °≈— ∫§◊ πµ— «¡“ Ÿà Õ“°“√°«— ¥·°«à ߥ— ß ‡™à π‡¥‘ ¡Õ’ °µà Õ‰ª ∂÷ ß·¡â «à “‡Õ ‚∑√- ‡®π®–‰¥â ∂Ÿ °√–ß— ∫‰ª ˜ «— π ·µà º≈ ¢Õß¡— π¬— ß§ßÕ¬Ÿà π“πæÕ∑’Ë ®–‡À≈◊Ë Õ¡ °— π°— ∫™à «ß∑’Ë ‡√‘Ë ¡„Àâ ‡Õ ‚∑√‡®π„π §√—È ßµà Õ‰ª ´÷Ë ß∑”„Àâ ‡√“Õ“®æ‘ ®“√≥“ ‰¥â «à “ ∂â “‡√“„™â √–¬– ∆Τ , p ·≈– ¢π“¥¢Õ߬“∑’Ë ∂Ÿ °µâ Õß °“√„Àâ ŒÕ√å - ‚¡πÕ“®®–‰¡à µâ Õß°√–∑”Õ¬à “ßµà Õ ‡π◊Ë Õßµ≈Õ¥‡«≈“ ‚¥¬∑’Ë net bone formation ®– “¡“√∂‡ªì π∑’Ë §“¥À«— ß ‰¥â ∂÷ ß·¡â «à “®–√–ß— ∫°“√„™â ŒÕ√å ‚¡π ∑¥·∑π‡ªì π∫“ß™à «ß ∫∑ √ÿ ª ®“°∑’Ë °≈à “«¡“¢â “ßµâ π®–‡ÀÁ π‰¥â «à “ °“√ √â “ßµ— «·∫∫·°π¢Õß√–∫∫ ∑’Ë ‡√“ π„®»÷ °…“ πÕ°®“°®–∑”„Àâ ‡√“ “¡“√∂‡¢â “„®√–∫∫¥— ß°≈à “«‰¥â ¥’ ¢÷È π·≈â « ¬— ß®– “¡“√∂„™â „π°“√ »÷ °…“°“√µÕ∫ πÕßµà Õ·ø°‡µÕ√å ¿“¬πÕ°µà “ß Ê µà Õ√–∫∫π—È π‰¥â ¥â «¬ ‚¥¬°“√¢¬“¬µ— «·∫∫·°π (Core Model) „Àâ §”π÷ ß∂÷ ߺ≈°√–∑∫®“° °“√°√–µÿâ π®“° ‘Ë ß·«¥≈â Õ¡ ‡™à π °“√ „™â ŒÕ√å ‚¡π‡Õ ‚∑√‡®π À√◊ Õ PTH ∑¥·∑π„π≈— °…≥–µà “ß Ê °— π ´÷Ë ß ®–™à «¬·æ∑¬å „π°“√«‘ π‘ ®©— ¬‚√§ ·≈– ¥Ÿ ·≈‡¬’ ¬«¬“ºŸâ ªÉ «¬∑’Ë ¡’ §«“¡º‘ ¥ª√°µ‘ „π√–∫∫°“√∑”ß“π„π√à “ß°“¬‰¥â Õ¬à “ß∂Ÿ °µâ Õ߇À¡“– ¡ °‘ µµ‘ °√√¡ª√–°“» ß“π«‘ ®— ¬π’È ‰¥â √— ∫°“√ π— ∫ πÿ π ∑ÿ π«‘ ®— ¬®“° ”π— °ß“π°Õß∑ÿ π π— ∫- πÿ π°“√«‘ ®— ¬ ( °«.) ‡Õ° “√Õâ “ßÕ‘ ß Albright, F., Smith, P.H., and Richardson, A.M., 1941. Postmenopausal osteoporosis. JAMA . 116, 2465- 2474. Brown, E.M., 1991. Extracellular Ca 2+ sensing, regulation of parathyroid cell function, and role of Ca 2+ and other ions as extracellular (first) messen- gers. Physiol. Rev. 71, 371-411. Burgess, T. L., Qian, Y., Kaufman, S., Ring, B.D., Van, G., Capparelli, C., Kelly, M., Hsu, H., Boyle, W.J., Dunstan, C.R.,Hu, S., and Lacey, D.L., 1999, The ligand for osteoprotegerin (OPGL) directly activates mature osteoclasts. J. Cell Biol . 145, 527- 538. DeCherney, A., 1993. Physiologic and pharmacologic effects of estrogen and progestins on Bone. J. Reprod. Med . 38(12) supplement, 1007- 1014. Heersche, J.N.M., and Cherk, S., 1989. Metabolic Bone Disease: cellular and tissue mechanisms , Boca Raton, FI: CRC Press. Isogai, Y. T., Akatsu, T., Ishizuya, T., Yamaguchi, A., Hori, M., Tokahashi, N., and Suda, T., 1996. Parathyroid hormone regulates osteoblast dif- ferentiation positively or negatively depending on differentiation stages. J. Bone Mineral Res. 11, 1384- 1393. Kong, Y.Y., Yoshida, H., Sarosi, I., Tan, H. L., Timms, E., Capparelli, C., Morony, S., Santos, A., Van, G., Itie, A., Khoo,W.,Wakeham,A., Dunstan, C., Lacey, D., Mak, T., Boyle, W., and Penninger, J., 1999. OPGL is a key regulator of osteoclastogenesis, lymphocyte development and lymph-node organogenesis. Nature 397, 315-323. Kroll, M. H., 2000. Parathyroid hormone temporal effects on bone formation and resorption. Bull. Math. Bio. 62, 163-188. Marcus, R., 1994. Osteoporosis , Black- well Scientific Publication. Takahashi, N., Udagawa, N., and Suda, T., 1999. A new member of tumor necrosis factor ligand family, ODF/ OPGL/TRANCE/RANKL, regulates osteoclast differentiation and function. Biochem. Biophys. Res. Commun. 256, 449-455. Turner, R.T., Lawrence, B.R., and Thomas, C. S., 1994. Skeletal effects of estrogen, Endocr. Rev. 15(3) , 275-300.