EÏÏËÓÈο ¢È·‚ËÙÔÏÔÁÈο XÚÔÓÈο 21, 2: 101 -110, 2008

AÓ·ÛÎfiËÛË

ªË ·ÏÎÔÔÏÈ΋ ÏÈ҉˘ ÓfiÛÔ˜ ÙÔ˘ ‹·ÙÔ˜

¢.£. ∫·Ú·Ì‹ÙÛÔ˜ ¶ÂÚ›ÏË„Ë

¢. ∫ÔÏÈÔ‡Ûη˜ ™ÙË ÌË ·ÏÎÔÔÏÈ΋ ÏÈÒ‰Ë ÓfiÛÔ ÙÔ˘ ‹·ÙÔ˜ (ª∞§¡∏) ÂÚÈÏ·Ì-
‚¿ÓÔÓÙ·È ‰‡Ô ÔÓÙfiÙËÙ˜: Ë ÌË ·ÏÎÔÔÏÈ΋ Ë·ÙÔÛÙ¿وÛË (ª∞∏) ηÈ
Ë ÛÔ‚·ÚfiÙÂÚË —ÏfiÁˆ Èı·Ó‹˜ ÂͤÏÈ͢ Û ΛÚÚˆÛË— ÌË ·ÏÎÔÔÏÈ΋
ÛÙ·ÙÔË·Ù›Ùȉ· (ª∞™). O ۷ί·Ú҉˘ ‰È·‚‹Ù˘ Î·È Ë ·¯˘Û·ÚΛ·
Â›Ó·È ÔÈ Û˘¯ÓfiÙÂÚ˜ ·Èٛ˜ Ù˘ ª∞§¡∏ Ì ·ÚÈÔ Ì˯·ÓÈÛÌfi ÙËÓ ·ÓÙ›-
ÛÙ·ÛË ÛÙËÓ ÈÓÛÔ˘Ï›ÓË. ¶ÚÔ¸fiıÂÛË ÁÈ· ÙË ‰È¿ÁÓˆÛË MA§¡∏ Â›Ó·È Ë
Ìˉ·ÌÈÓ‹ ‹ ÂÏ¿¯ÈÛÙË ÚfiÛÏË„Ë ÔÈÓÔÓ‡̷ÙÔ˜. ∏ ÎÚ˘„ÈÁÂÓ‹˜ ΛÚ-
ÚˆÛË ÔÊ›ÏÂÙ·È Î·Ù¿ ηÓfiÓ· Û ª∞™. ∏ ·‡ÍËÛË Ù˘ Û˘¯ÓfiÙËÙ·˜ Ù˘
·¯˘Û·ÚΛ·˜ Î·È ÙÔ˘ ™¢ Ù‡Ô˘ 2 Ô˘ ·Ú·ÙËÚÂ›Ù·È ·ÁÎÔÛÌ›ˆ˜ ›-
Ó·È ·ÈÙ›· Ô˘ ı· Ô‰ËÁ‹ÛÂÈ Û ·‡ÍËÛË ÙˆÓ ÂÚÈÙÒÛÂˆÓ ª∞§¡∏.
™ÙËÓ ·Ó·ÛÎfiËÛË ·˘Ù‹ ·ÚÔ˘ÛÈ¿˙ÔÓÙ·È ÂȉËÌÈÔÏÔÁÈο Î·È ·ıÔÏÔ-
ÁÔ·Ó·ÙÔÌÈο ÛÙÔȯ›·, Û˘˙ËÙÂ›Ù·È Ë ·ıÔÁ¤ÓÂÈ·, Ë ‰È¿ÁÓˆÛË, Ë Úfi-
ÁÓˆÛË Î·È ÔÈ ÚÔÙÂÈÓfiÌÂÓ˜ ıÂÚ·¢ÙÈΤ˜ ÂÈÏÔÁ¤˜.

∏ Û˘ÛÛÒÚ¢ÛË Ï›Ô˘˜ ÛÙ· Ë·ÙÔ·ÙÙ·Ú· ÂÚÈÁÚ·ÊfiÙ·Ó ·-

Ï·ÈfiÙÂÚ· ˆ˜ ÏÈ҉˘ ‰È‹ıËÛË ÙÔ˘ ‹·ÙÔ˜. ∞˘Ùfi˜ ‹Ù·Ó ¤Ó·˜ fiÚÔ˜
ÎÏÈÓÈÎfi˜ Î·È ·ıÔÏÔÁÔ·Ó·ÙÔÌÈÎfi˜. ¢ÂÓ ÚfiÎÂÈÙ·È fï˜ ÁÈ· ‰È‹-
ıËÛË ÙÔ˘ ‹·ÙÔ˜ ·fi ·˘ÙÔÙÂÏ‹ ÏÈÔ·ÙÙ·Ú·, ·ÏÏ¿ ÁÈ· Ë·ÙÔ·Ù-
Ù·Ú· Ô˘ ÂÚȤ¯Ô˘Ó ÂÓ·Ôı¤ÛÂȘ Ï›Ô˘˜. ∏ ÔÓÔÌ·Û›· ÏÈ҉˘
‰È‹ıËÛË ·ÓÙÈηٷÛÙ¿ıËΠÚÔ 30 ÂÙÒÓ ÂÚ›Ô˘ ·fi ÙÔÓ fiÚÔ ÏÈ-
҉˜ ‹·Ú, Ô˘ Â›Ó·È ¤Ó·˜ ÁÂÓÈÎfi˜ ·ıÔÏÔÁÔ·Ó·ÙÔÌÈÎfi˜ fiÚÔ˜,
·ÏÏ¿ Ù· ÙÂÏÂ˘Ù·›· ¯ÚfiÓÈ· ηıÈÂÚÒıËΠӷ ·Ó·Ê¤ÚÂÙ·È —Û ·ÓÙÈ-
‰È·ÛÙÔÏ‹ ÚÔ˜ ÙËÓ ·ÏÎÔÔÏÈ΋ ÏÈÒ‰Ë ÓfiÛÔ ÙÔ˘ ‹·ÙÔ˜— ˆ˜ «ÌË
·ÏÎÔÔÏÈ΋ ÏÈ҉˘ ÓfiÛÔ˜ ÙÔ˘ ‹·ÙÔ˜» (ª∞§¡∏). ∏ ÙÂÏÂ˘Ù·›·
ÂÚÈÏ·Ì‚¿ÓÂÈ Î˘Ú›ˆ˜ ‰‡Ô ÔÓÙfiÙËÙ˜:
·) ÙËÓ Î·ÏÔËı¤ÛÙÂÚË ÌË ·ÏÎÔÔÏÈ΋ Ë·ÙÔÛÙ¿وÛË (ª∞∏)
‚) ÙË ÛÔ‚·ÚfiÙÂÚË ÌË ·ÏÎÔÔÏÈ΋ ÛÙ·ÙÔË·Ù›Ùȉ· (ª∞™).
º˘ÛÈο ‹‰Ë ·fi ÙËÓ ÔÓÔÌ·Û›· ÚÔ·ÙÂÈ ‰È·ÊÔÚÔÔ›ËÛË
·fi ÙËÓ ·ÏÎÔÔÏÈ΋ ÏÈÒ‰Ë ÓfiÛÔ ÙÔ˘ ‹·ÙÔ˜ Ì ÙËÓ ÔÔ›· ˘¿Ú-
¯Ô˘Ó ÎÔÈÓ¿ ·ıÔÏÔÁÔ·Ó·ÙÔÌÈο ¯·Ú·ÎÙËÚÈÛÙÈο1. ∂›Ó·È Ì¿ÏÈÛÙ·
··Ú·›ÙËÙÔ Ô ÎÏÈÓÈÎfi˜ ÁÈ·ÙÚfi˜ Ó· Â›Ó·È Û ı¤ÛË Ó· ÁÓˆÚ›˙ÂÈ ÙÔÓ
‚·ıÌfi ¯Ú‹Û˘ ‹ ÌË ÙÔ˘ ÔÈÓÔÓ‡̷ÙÔ˜ ·fi ÙÔÓ ·ÛıÂÓ‹ ÙÔ˘ ÁÈ· Ó·
ÂÈϤÍÂÈ ÙË ‰È¿ÁÓˆÛË.
∞′ ¶ÚÔ·È‰Â˘ÙÈ΋ EȉËÌÈÔÏÔÁ›·
¶·ıÔÏÔÁÈ΋ ∫ÏÈÓÈ΋, ¶ÏËÚÔÊÔڛ˜ ÁÈ· ÙÔÓ ÂÈÔÏ·ÛÌfi Ù˘ ª∞§¡∏ ˘¿Ú¯Ô˘Ó ·)
∞ÚÈÛÙÔÙ¤ÏÂÈÔ ¶·ÓÂÈÛÙ‹ÌÈÔ ·fi ˘ÂÚ˯ÔÁÚ·ÊÈΤ˜ ÌÂϤÙ˜, ‚) ·fi ‚ÈÔ¯ËÌÈΤ˜ ÌÂÙÚ‹ÛÂȘ, Á)
£ÂÛÛ·ÏÔӛ΢, ·fi ‚ÈÔ„›Â˜, ‰) ·fi ÓÂÎÚÔÙÔ̤˜ Î·È Â) ·fi Ì·ÁÓËÙÈ΋ Ê·ÛÌ·ÙÔ-
¶.°. ¡ÔÛÔÎÔÌÂ›Ô ∞Ã∂¶∞ ÛÎÔ›·. øÛÙfiÛÔ, ‰ÂÓ ˘¿Ú¯Ô˘Ó Ú·ÁÌ·ÙÈο ÏËı˘ÛÌȷΤ˜ ÂȉË-
£ÂÛÛ·ÏÔӛ΢ ÌÈÔÏÔÁÈΤ˜ ÌÂϤÙ˜ Ù˘ ª∞∏ Î·È Ù˘ ª∞™. OÈ ÂÚÈÛÛfiÙÂÚ˜ ÂÚÁ·-
 EÏÏËÓÈο ¢È·‚ËÙÔÏÔÁÈο XÚÔÓÈο 21, 2
ۛ˜ ·ÊÔÚÔ‡Ó Û ÌÈÎÚÔ‡˜ ·ÚÈıÌÔ‡˜ ·ÙfiÌˆÓ Â›Ù ·-
¯˘Û¿ÚÎˆÓ Â›Ù ‰È·‚ËÙÈÎÒÓ. OÈ ÂÚÈÛÛfiÙÂÚ˜ ÌÂϤ-
Ù˜ ¤¯Ô˘Ó ˆ˜ ÎÚÈÙ‹ÚÈÔ ·ÂÈÎÔÓÈÛÙÈο Î·È ‚ÈÔ¯ËÌÈο
¯·Ú·ÎÙËÚÈÛÙÈο, Ì ٷ ÔÔ›· ‰ÂÓ Á›ÓÂÙ·È ‰È¿ÎÚÈÛË
Ù˘ Ë·ÙÔÛÙ¿وÛ˘ ·fi ÙË ÛÙ·ÙÔË·Ù›Ùȉ·. ÀÔ-
ÏÔÁ›˙ÂÙ·È fiÙÈ ÛÙȘ ∏¶∞ —Ô˘ Â›Ó·È ¯ÒÚ· Ì ÌÂÁ¿-
ÏÔ ÔÛÔÛÙfi ·¯‡Û·ÚÎˆÓ ·Ùfïӗ ÙÔ 75% ÙˆÓ ·-
¯‡Û·ÚÎˆÓ ·ÙfiÌˆÓ ‹ ÙˆÓ ‰È·‚ËÙÈÎÒÓ Ì ™¢ Ù‡Ô˘ 2
¤¯ÂÈ ª∞§¡∏, ÂÓÒ 20% ÙˆÓ ·¯˘Û¿ÚÎˆÓ ¤¯ÂÈ
ª∞™1.
H ·¯˘Û·ÚΛ· Î·È Ë ·ÓÙ›ÛÙ·ÛË ÛÙËÓ ÈÓÛÔ˘Ï›-
ÓË ·ÔÙÂÏÔ‡Ó ·˘ÙÔÙÂÏ‹ ·Ú¿ÁÔÓÙ· ª∞§¡∏ ηÈ,
‰Â‰Ô̤ÓÔ˘ fiÙÈ ÙÔ 80% ÙˆÓ ·ÙfiÌˆÓ Ì ™¢ Ù‡Ô˘ 2
Â›Ó·È ¿ÙÔÌ· ·¯‡Û·Úη, ÂÍËÁÂ›Ù·È ¤ÌÌÂÛ· Î·È Ë
Û˘Û¯¤ÙÈÛË Ì ÙÔÓ ‰È·‚‹ÙË. O ™¢ ·˘Ùfi˜ ηı·˘Ùfi˜
Â›Û˘ Û¯ÂÙ›˙ÂÙ·È Ì ÙË ª∞§¡∏, fï˜ ¤¯ÂÈ ‚ÚÂ-
ı› ÈÛ¯˘ÚfiÙÂÚË Û˘Û¯¤ÙÈÛË Ù˘ ª∞§¡∏ Ì ÙËÓ ·-
¯˘Û·ÚΛ· Î·È ÏÈÁfiÙÂÚÔ Ì ÙÔÓ ‰È·‚‹ÙË2. øÛÙfiÛÔ,
ÛÙ· ȉȷÈÙ¤Úˆ˜ ·¯‡Û·Úη ¿ÙÔÌ· Ë Û˘Ó‡·ÚÍË ™¢
·˘Í¿ÓÂÈ ÂÙ¿ ÊÔÚ¤˜ ÙÔÓ Î›Ó‰˘ÓÔ Ù˘ ÂÌÊ¿ÓÈÛ˘
›ÓˆÛ˘ ÛÙÔ ‹·Ú3-5. H ÂÓ·fiıÂÛË Ï›Ô˘˜ ÛÙÔ ‹·Ú
ÙˆÓ ·ÛıÂÓÒÓ Ì ™¢ ıˆÚÂ›Ù·È fiÙÈ Â›Ó·È Ôχ Û˘-
¯Ófi Ê·ÈÓfiÌÂÓÔ Î·È ·ÊÔÚ¿ ΢ڛˆ˜ Û ¿ÙÔÌ· Ì ™¢
Ù‡Ô˘ 2 Î·È ÌfiÓÔ Û 15% ÙˆÓ ·ÙfiÌˆÓ Ô˘ ¤¯Ô˘Ó
™¢ Ù‡Ô˘ 16.
H ·‡ÍËÛË ÙÔ˘ Ï›Ô˘˜ ÛÙÔ ‹·Ú ÙˆÓ ‰È·‚ËÙÈ-
ÎÒÓ Êı¿ÓÂÈ, ·fi ÙÔ Ê˘ÛÈÔÏÔÁÈÎfi Ô˘ Â›Ó·È <5%,
Û 30%-40% ÙÔ˘ ‚¿ÚÔ˘˜ ÙÔ˘ ‹·ÙÔ˜, ÁÂÁÔÓfi˜ Ô˘
ÂȂ‚·ÈÒÓÂÙ·È ÈÛÙÔÏÔÁÈο. H ˘¤Ú‚·ÛË ÙÔ˘ Ê˘-
ÛÈÔÏÔÁÈÎÔ‡ ÔÚ›Ô˘ ÙÔ˘ 5% Â›Ó·È ÚÔ¸fiıÂÛË ÁÈ· Ó·
ÙÂı› Ë ÁÂÓÈ΋ ‰È¿ÁÓˆÛË Ù˘ ª∞§¡∏7.
H Û˘¯ÓfiÙËÙ· Ù˘ ª∞§¡∏ Û ·ÛıÂÓ›˜ ÌÂ
ÚfiÛÊ·Ù· ‰È·ÁÓˆṲ̂ÓÔ ™¢ Ù‡Ô˘ 2 ·Ó¤Ú¯ÂÙ·È ÛÙÔ
50%8,9. ŸÙ·Ó fï˜ Û˘Ó‰˘¿˙ÂÙ·È Ô ™¢ Ì ·¯˘-
Û·ÚΛ· ۯ‰fiÓ fiÏ· Ù· ¿ÙÔÌ· ¤¯Ô˘Ó ÙÔ˘Ï¿¯ÈÛÙÔÓ
ÂÏ·ÊÚ¿˜ ÌÔÚÊ‹˜ Ë·ÙÔÛÙ¿وÛË, ÂÓÒ ¿Ó¢ ·¯˘-
Û·ÚΛ·˜ ÙÔ ÔÛÔÛÙfi Â›Ó·È ÌÈÎÚfiÙÂÚÔ3.
O fiÚÔ˜ ÛÙ·ÙÔË·Ù›Ùȉ· ηıÈÂÚÒıËΠÙÔ
1980 ÁÈ· Ó· ÂÚÈÁÚ¿„ÂÈ ÌÈ· ÎÏÈÓÈ΋ ÔÓÙfiÙËÙ· ÌÂ
·ÚfiÌÔÈ· ÈÛÙÔÏÔÁÈο Â˘Ú‹Ì·Ù· Û·Ó ·˘Ù¿ Ô˘
˘¿Ú¯Ô˘Ó ÛÙËÓ ·ÏÎÔÔÏÈ΋ Ë·Ù›Ùȉ· Û ·ÛıÂÓ›˜
Ô˘ ‰ÂÓ Î·Ù·Ó¿ÏˆÓ·Ó fï˜ ÛËÌ·ÓÙÈ΋ ÔÛfiÙËÙ·
·ÏÎÔfiÏ. °È· Ó· ıˆÚËı› ÌÈ· ÛÙ·ÙÔË·Ù›Ùȉ· ÌË
·ÏÎÔÔÏÈ΋ Ú¤ÂÈ:
·. Ó· ÌËÓ ˘¿Ú¯ÂÈ ¿ÏÏË ·ÈÙÈÔÏÔÁ›· Ë·ÙÔ¿-
ıÂÈ·˜ ηÈ
‚. Ë ÔÛfiÙËÙ· ÔÈÓÔÓ‡̷ÙÔ˜ Ô˘ ηٷӷϛ-
ÛÎÂÙ·È Ó· ÌËÓ ˘ÂÚ‚·›ÓÂÈ Ù· 20 g/24ˆÚÔ ÁÈ· ÙÔ˘˜
¿Ó‰Ú˜ Î·È Ù· 10 g/24ˆÚÔ ÁÈ· ÙȘ Á˘Ó·›Î˜10.
∏ ª∞™ ıˆÚÂ›Ù·È fiÙÈ ÌÔÚ› Ó· ÂÍÂÏȯı› ÛÂ
ΛÚÚˆÛË ‹·ÙÔ˜, ·ÏÏ¿ οÙÈ Ù¤ÙÔÈÔ Û˘Ó‹ıˆ˜ ··È-
102
Ù› ·ÚÎÂÙ¿ ¯ÚfiÓÈ· Î·È Â˘Ù˘¯Ò˜ ‰ÂÓ Â›Ó·È Ë ÈÔ Û˘-
¯Ó‹ ÂͤÏÈÍË6,11. ∏ ª∞§¡∏ Â›Ó·È Ë ÈÔ Û˘¯Ó‹ Ë·-
ÙÈ΋ ÓfiÛÔ˜ ÛÙÔ˘˜ ·ÛıÂÓ›˜ Ì ™¢12. ∏ ª∞§¡∏
‚ÂÏÙÈÒÓÂÙ·È ÛÂ ÛËÌ·ÓÙÈÎfi ‚·ıÌfi ÌÂÙ¿ ·fi ·ÒÏÂÈ·
‚¿ÚÔ˘˜, .¯., ÌÂÙ¿ ·fi ‚·ÚÈ·ÙÚÈΤ˜ ÂÂÌ‚¿ÛÂȘ13.
∞fi Ù· ¿ÙÔÌ· Ô˘ ¤¯Ô˘Ó ª∞§¡∏ Î·È ˘Ô‚¿ÏÏÔ-
ÓÙ·È Û ‚ÈÔ„›· ‹·ÙÔ˜ ÙÔ 31% ¤¯ÂÈ ª∞∏, ÙÔ 50%
¤¯ÂÈ ÛÙ·ÙÔË·Ù›Ùȉ· Î·È ÙÔ 19% ¤¯ÂÈ Î›ÚÚˆÛË.
øÛÙfiÛÔ ÙÔ ˘ÏÈÎfi ·˘Ùfi Â›Ó·È È‰È·›ÙÂÚ· ÂÎÏÂÎÙÈÎfi ηÈ
‰ÂÓ Â›Ó·È ·Ó¿ÏÔÁÔ ÙÔ˘ Û˘ÓÔÏÈÎÔ‡ ÏËı˘ÛÌÔ‡ Ô˘
¤¯ÂÈ ª∞§¡∏ Û ÔÔÈ·‰‹ÔÙ ÌÔÚÊ‹14.
¢Â‰Ô̤ÓÔ˘ fiÙÈ Ë ª∞™ Â›Ó·È ÌÈ· Ë·ÙÔ¿ıÂÈ·
Ô˘ ÌÔÚ› Ó· ÂÍÂÏȯı› Û ΛÚÚˆÛË ‹·ÙÔ˜15,16 Ù·
ÛÙ¿‰È· Ù˘ ÌË ·ÏÎÔÔÏÈ΋˜ ÓfiÛÔ˘ ÙÔ˘ ‹·ÙÔ˜ ÌÔ-
Ú› ıˆÚËÙÈο Ó· Â›Ó·È Î·Ù¿ ÛÂÈÚ¿:
Ë·ÙÔÛÙ¿وÛË → ÛÙÂÙÔË·Ù›Ùȉ· → ΛÚÚˆÛË - - -> ηÚΛÓÔ˜
øÛÙfiÛÔ, Ë ÌÂÙ¿ÙˆÛË Ù˘ ª∞∏ Û ª∞™ ›-
Ó·È ·ÎfiÌË ¤Ó· ·ÚÎÂÙ¿ ·‰È¢ÎÚ›ÓÈÛÙÔ ı¤Ì· ‰Â‰Ô-
̤ÓÔ˘ fiÙÈ, Û ·‰Ú¤˜ ÁÚ·Ì̤˜, ÂÓÒ ÂÚ›Ô˘ 20%
ÙÔ˘ ÂÓËÏ›ÎÔ˘ ÏËı˘ÛÌÔ‡ ÙˆÓ ·ÓÂÙ˘ÁÌ¤ÓˆÓ ¯ˆ-
ÚÒÓ ¤¯ÂÈ ª∞∏, ÌfiÓÔ 3%-5% ¤¯ÂÈ ª∞™17.
∫ÏÈÓÈΤ˜ Û˘Û¯ÂÙ›ÛÂȘ. ∏ ª∞§¡∏ ·Ú·ÙË-
ÚÂ›Ù·È Û ¿ÙÔÌ· Ô˘ Â›Ó·È ·¯‡Û·Úη, Ô˘ ¤¯Ô˘Ó
™¢ Ù‡Ô˘ ‹/Î·È ˘ÂÚÙÚÈÁÏ˘ÎÂÚȉ·ÈÌ›·, Ô˘ ¤¯Ô˘Ó
¯¿ÛÂÈ ‚¿ÚÔ˜ Ì ÌÂÁ¿ÏË Ù·¯‡ÙËÙ·, ÁÈ· ·Ú¿‰ÂÈÁÌ·,
‡ÛÙÂÚ· ·fi ‚·ÚÈ·ÙÚÈΤ˜ ÂÂÌ‚¿ÛÂȘ ÁÈ· ·ÓÙÈÌÂÙÒ-
ÈÛË ÓÔÛËÚ‹˜ ·¯˘Û·ÚΛ·˜. ∂›Û˘ ·Ú·ÙËÚ›ٷÈ
‡ÛÙÂÚ· ·fi Ï‹„Ë ‰È·ÊfiÚˆÓ Ê·ÚÌ¿ÎˆÓ (¶›Ó. 1).
™Â ˘ÂÚ‚ÔÏÈο ·¯‡Û·Úη ¿ÙÔÌ· Ô˘ ¯ÂÈÚÔ˘ÚÁ‹-
ıËÎ·Ó ÁÈ· ·ÓÙÈÌÂÙÒÈÛË Ù˘ ·¯˘Û·ÚΛ·˜, 27% ›-
¯·Ó ÛÔ‚·Ú‹ Ë·ÙÔÛÙ¿وÛË Ì ϛÔ˜ ÛÙÔ ‹·Ú
>60% ÙÔ˘ ‚¿ÚÔ˘˜ ÙÔ˘ (∂ÈÎ. 1)18.
¶·Ú¿ÁÔÓÙ˜ Ô˘ Úԉȷı¤ÙÔ˘Ó ÁÈ· ª∞™ ›-
Ó·È Ë Î·Ù·Ó¿ÏˆÛË ÎÂÎÔÚÂÛÌ¤ÓˆÓ ÏÈ·ÚÒÓ ÔͤˆÓ
Î·È ÔÏÏÒÓ ˘‰·Ù·ÓıڿΈÓ. ŒÙÛÈ, Ë Î·Ù·Ó¿ÏˆÛË
ÎÂÎÔÚÂÛÌ¤ÓˆÓ ÏÈ·ÚÒÓ ÔͤˆÓ Û¯ÂÙ›ÛÙËΠ̠ÙË
ÌÂÙ·ÁÂ˘Ì·ÙÈ΋ ÏÈ·ÈÌ›· Û ¿ÙÔÌ· Ô˘ ›¯·Ó
ª∞™19 Î·È Ë Î·Ù·Ó¿ÏˆÛË ˘‰·Ù·ÓıÚ¿ÎˆÓ Û¯ÂÙ›-
ÛÙËΠ̠ÙË ÊÏÂÁÌÔÓÒ‰Ë ÂÍÂÚÁ·Û›· ÙÔ˘ ‹·ÙÔ˜20.
¶·ıÔÁ¤ÓÂÈ·. ∏ ·ıÔÁ¤ÓÂÈ· Ù˘ ÌË ·ÏÎÔÔÏÈ-
΋˜ ÏÈÒ‰Ô˘˜ ÓfiÛÔ˘ ÙÔ˘ ‹·ÙÔ˜ ‰ÂÓ Â›Ó·È Ï‹Úˆ˜
‰È¢ÎÚÈÓÈṲ̂ÓË. ∏ ÛÙ¿وÛË ·ÔÙÂÏ› ·ÓÙ·Ó¿ÎÏ·-
ÛË Ù˘ ηٷÎÚ¿ÙËÛ˘ ÏÈȉ›ˆÓ ̤۷ ÛÙ· Ë·ÙÈο
·ÙÙ·Ú·. ∏ Û˘ÛÛÒÚ¢ÛË ÙÔ˘ Ï›Ô˘˜ Â›Ó·È ·ÔÙ¤-
ÏÂÛÌ· Ù˘ ·ÓÈÛÔÚÚÔ›·˜ ÌÂٷ͇ Ù˘ ÚfiÛÏ˄˘
Î·È Û‡ÓıÂÛ˘ ÏÈ·ÚÒÓ ÔͤˆÓ ¤Ó·ÓÙÈ Ù˘ ÔÍ›‰ˆ-
Û˘ Î·È Ù˘ ÂÍfi‰Ô˘ ÙÔ˘˜ ·fi ÙÔ ‹·Ú. ¶ÈÔ ÂȉÈο,
Ë ·ÓÙ›ÛÙ·ÛË ÛÙËÓ ÈÓÛÔ˘Ï›ÓË ¤¯ÂÈ ˆ˜ ·ÔÙ¤ÏÂÛÌ·
·‰˘Ó·Ì›· ·ÓÙÈÚÚfiËÛ˘ Ù˘ ÏÈfiÏ˘Û˘, ÌÂ Û˘Ó¤-
ÂÈ· Ó· ·˘Í¿ÓÂÙ·È Ë Î˘ÎÏÔÊÔÚ›· ÙˆÓ ÂχıÂÚˆÓ
 EÏÏËÓÈο ¢È·‚ËÙÔÏÔÁÈο XÚÔÓÈο 21, 2
¶›Ó·Î·˜ 1. ∞Èٛ˜ ÌË ·ÏÎÔÔÏÈ΋˜ ÏÈÒ‰Ô˘˜ ÓfiÛÔ˘ ÙÔ˘ ‹·-
ÙÔ˜.
∫·ÙËÁÔÚ›· ·ÈÙ›ˆÓ ∞›ÙÈ· ·Ó·Ï˘ÙÈο
¶ÚˆÙÔ·ı‹˜ ¶·¯˘Û·ÚΛ·, ™¢ Ù‡Ô˘ 2,
ÀÂÚÙÚÈÁÏ˘ÎÂÚȉ·ÈÌ›·,
∞ÚÙËÚȷ΋ ˘¤ÚÙ·ÛË
¢È·ÙÚÔÊÈο ÀÔıÚ„›·, Δ·¯Â›· ·ÒÏÂÈ· ‚¿ÚÔ˘˜,
ÃÂÈÚÔ˘ÚÁÈΤ˜ ÂÂÌ‚¿ÛÂȘ
·¯˘Û·ÚΛ·˜, ¶·ÚÂÓÙÂÚÈ΋ ‰È·ÙÚÔÊ‹
º¿Ú̷η ∫ÔÚÙÈÎÔÛÙÂÚÔÂȉ‹, OÈÛÙÚÔÁfiÓ·,
Δ·ÌÔÍÈʤÓË, ∞ÌÈÔ‰·ÚfiÓË,
ªÂıÔÙÚÂÍ¿ÙË, ¢ÈÏÙÈ·˙¤ÌË, ∑È‰Ô‚Ô˘-
ÓÙ›ÓË, μ·ÏÚÔ˚Îfi Ô͇, ∞ÛÈÚ›ÓË,
ΔÂÙڷ΢ÎÏ›ÓË, ∫ÔÎη˝ÓË
ªÂÙ·‚ÔÏÈο §ÈÔ‰˘ÛÙÚÔÊ›·, ÀÔ-˘ÔÊ˘ÛÈÛÌfi˜,
¢˘Û‚ËÙ·ÏÈÔÚˆÙÂ˚Ó·ÈÌ›·, ¡fiÛÔ˜
Weber-Christian
ΔÔ͛Ә Amanita Phalloides, ¢ËÏËÙËÚ›·ÛË ÌÂ
ʈÛÊfiÚÔ, ¶ÂÙÚÔ¯ËÌÈο, ΔÔÍ›ÓË
‚·Î›ÏÔ˘ Cereus
§ÔÈÌÒÍÂȘ πfi˜ ∞πDS, πfi˜ ∏·Ù›Ùȉ·˜ C, ∂ÎÎÔÏ-
ˆÌ¿ÙˆÛË ÏÂÙÔ‡ ÂÓÙ¤ÚÔ˘ Ì ˘ÂÚ·-
Ó¿Ù˘ÍË ‚·ÎÙËÚ›ˆÓ
ÏÈ·ÚÒÓ ÔͤˆÓ (∂§O) Ô˘ ÚÔ¤Ú¯ÔÓÙ·È ·fi ÙÔÓ
ÏÈÒ‰Ë ÈÛÙfi, Ù· ÔÔ›· Î·È ÂÈÛ¤Ú¯ÔÓÙ·È ÛÙÔ ‹·Ú.
¶·ÚfiÌÔÈÔ ·ÔÙ¤ÏÂÛÌ· ¤¯ÂÈ Ë ·˘ÍË̤ÓË ÚfiÛÏË„Ë
ıÂÚÌ›‰ˆÓ, ÏfiÁˆ ·‡ÍËÛ˘ ÙˆÓ Â͈ÁÂÓÒ˜ ÚÔÛÊÂ-
ÚfiÌÂÓˆÓ ÛÙÔ ‹·Ú ÙÚÈÁÏ˘ÎÂÚȉ›ˆÓ Ô˘ ·ÔÚÚÔ-
ÊÒÓÙ·È ·fi ÙÔ ¤ÓÙÂÚÔ2.
∂Í¿ÏÏÔ˘, Ù· ·˘ÍË̤ӷ ∂§O Î·È Ù· ÚÔ˚fiÓÙ·
ÌÂÙ·‚ÔÏÈÛÌÔ‡ ÙÔ˘ Ï›Ô˘˜ ÛÙÔ˘˜ Ì˘˜ ÚÔηÏÔ‡Ó
·ÓÙ›ÛÙ·ÛË ÛÙËÓ ÈÓÛÔ˘Ï›ÓË Ì¤Ûˆ ÂÓÂÚÁÔÔÈ‹Ûˆ˜
Ù˘ ƒ∫C Theta Î·È Û˘Ì‚¿ÏÏÔ˘Ó ÛÙË ‰ËÌÈÔ˘ÚÁ›·
ÂÓfi˜ Ê·‡ÏÔ˘ ·ÎÏÔ˘ ÌÂٷ͇ ·ÓÙ›ÛÙ·Û˘ ÛÙËÓ ÈÓ-
ÛÔ˘Ï›ÓË Î·È Ï›Ô˘˜21. ∏ ·‡ÍËÛË ÙˆÓ ∂§O ÛÙ· ÌÈ-
ÙÔ¯fiÓ‰ÚÈ· ˘ÂÚÊÔÚÙÒÓÂÈ ÙÔ Û‡ÛÙËÌ· Ù˘ ‚-ÔÍ›-
‰ˆÛ˘ Î·È Ù· ÏÈ·Ú¿ Ôͤ· Û˘ÛÛˆÚ‡ÔÓÙ·È ÛÙÔ
‹·Ú. Δ· ·˘ÍË̤ӷ ÏÈ·Ú¿ Ôͤ· ÂÓÂÚÁÔÔÈÔ‡Ó
ÛÙÔ ‹·Ú, ÂȉÈο ÛÙÔ Î˘Ùfi¯ÚˆÌ· ƒ450, Ù· 4∞ ηÈ
2∂1 ÈÛÔ¤Ó˙˘Ì· (ÏÈÔ͢ÁÂÓ¿Û˜) Ô˘ ·Ú¿ÁÔ˘Ó
ÂχıÂÚ˜ Ú›˙˜ Ô͢ÁfiÓÔ˘ Î·È ·ÔÛÙ·ıÂÚÔÔÈÔ‡Ó
Ù· Ï˘ÛÔÛÒÌ·Ù·22,23. OÈ ÂχıÂÚ˜ Ú›˙˜ ÚÔ¿ÁÔ˘Ó
ÙËÓ ÂͤÏÈÍË Ù˘ ÓfiÛÔ˘, ̤ۈ Ù˘ ˘ÂÚÔÍ›‰ˆÛ˘
ÙˆÓ ÏÈȉ›ˆÓ Î·È Ù˘ ÂÓÂÚÁÔÔ›ËÛ˘ ΢ÙÙ·ÚÔÎÈ-
ÓÒÓ, fiˆ˜ MCP-1 Î·È IL-6 ·ÏÏ¿ Î·È TNF-a (·˘Í¿-
ÓÂÈ ÙËÓ ·fiÙˆÛË Î˘ÙÙ¿ÚˆÓ) Î·È ΔGF-‚ (ÚÔ¿ÁÂÈ
ÙËÓ ›ÓˆÛË), ÂÓÒ ÂÏ·ÙÙÒÓÂÙ·È Ë ·‰ÈÓÔÔÓÂÎÙ›ÓË
(΢ÙÙ·ÚÔΛÓË Ô˘ ¢·ÈÛıËÙÔÔÈ› Ù· ·ÙÙ·Ú· ÛÙËÓ
ÈÓÛÔ˘Ï›ÓË Î·È ¤¯ÂÈ ‰Ú¿ÛË ·ÓÙ›ıÂÙË ÚÔ˜ ÙÔÓ Δ¡F-
a)24. ∏ ·Ú·ÁˆÁ‹ ÔÚÈÛÌ¤ÓˆÓ Î˘ÙÙ·ÚÔÎÈÓÒÓ Â›Ó·È
ÁÓˆÛÙfi fiÙÈ ÚÔ¿ÁÂÈ ÙË ‰È·‰Èηۛ· Ù˘ ÊÏÂÁÌÔ-
EÈÎ. 1. ∏ Û˘ÛÛÒÚ¢ÛË Ï›Ô˘˜ ÛÙ· Ë·ÙÔ·ÙÙ·Ú· ·ÏÏ¿-
˙ÂÈ ÙËÓ ÂÌÊ¿ÓÈÛË (ÔÚÙÔηϛ ¯ÚÒÌ·) Î·È ÙÔ Ì¤ÁÂıÔ˜
ÙÔ˘ ‹·ÙÔ˜.
Ó‹˜25,26.
∏ ·ÓÈÛÔÚÚÔ›· ÌÂٷ͇ ÔÍÂȉˆÙÈÎÒÓ Î·È ·-
ÓÙÈÔÍÂȉˆÙÈÎÒÓ Ô˘ÛÈÒÓ Úԉȷı¤ÙÂÈ ÁÈ· ÌÂÁ·Ï‡ÙÂ-
ÚÔ ‚·ıÌfi ÛÙ¿وÛ˘, fiÙ·Ó Ù· Ë·ÙÈο ·ÙÙ·Ú·
ÂÎÙ›ıÂÓÙ·È Û ÂχıÂÚ˜ Ú›˙˜ Ô͢ÁfiÓÔ˘27.
∏ ˘ÂÚÔÍ›‰ˆÛË ÙˆÓ ÏÈȉ›ˆÓ Ô‰ËÁ› Û ÂÏ¢-
ı¤ÚˆÛË Ì·ÏÔÓÈ΋˜ ‰È·Ï‰Â˛‰Ë˜ Î·È Ì-˘‰ÚÔ͢ÓÔÓÂ-
¿Ï˘. ∞˘Ù¤˜ ÔÈ Ô˘Û›Â˜ ÚÔηÏÔ‡Ó Î˘ÙÙ·ÚÈÎfi ı¿Ó·-
ÙÔ Î·È ·ÏÏ·Á¤˜ ÛÙË ‰ÔÌ‹ ÚˆÙÂ˚ÓÒÓ (‰È·ÛÙ·˘ÚÔ‡-
ÌÂÓÔ˘˜ ‰ÂÛÌÔ‡˜), Ì ÙÂÏÈÎfi ·ÔÙ¤ÏÂÛÌ· ÙÔÓ Û¯Ë-
Ì·ÙÈÛÌfi ˘·Ï›Ó˘ ÙÔ˘ Mallory ÛÙ· Ë·ÙÔ·ÙÙ·Ú·28.
ΔÂÏÈο, Ë ·ÓÙ›ÛÙ·ÛË ÛÙËÓ ÈÓÛÔ˘Ï›ÓË (Ô˘ Ú·-
ÎÙÈο Â›Ó·È Û˘ÓÒÓ˘ÌÔ˜ fiÚÔ˜ Ì ÙË ÌÂÈÔÓÂÎÙÈ΋ ÈÓ-
ÛÔ˘ÏÈÓÈ΋ ‰Ú¿ÛË) Ô‰ËÁ› Û ·‡ÍËÛË Ù˘ ÁÏ˘ÎÔÓÂÔ-
Á¤ÓÂÛ˘, ·ÓÂ·Ú΋ ÌÂÙ·‚ÔÏÈÛÌfi ÙˆÓ ∂§O ηÈ
ÂÏ¿ÙÙˆÛË Ù˘ ÂÍfi‰Ô˘ ÙÚÈÁÏ˘ÎÂÚȉ›ˆÓ ·fi ÙÔ ‹·Ú
ˆ˜ VLDL Ì ·ÔÙ¤ÏÂÛÌ· ÙËÓ Ë·ÙÈ΋ ÛÙ¿وÛË.
Δ· ·Ú·¿Óˆ ·ÔÙÂÏÔ‡Ó ÙÔ ÚÒÙÔ ÛΤÏÔ˜ Ù˘
·ÔηÏÔ‡ÌÂÓ˘ ˘fiıÂÛ˘ ÙˆÓ ‰‡Ô ¯Ù˘ËÌ¿ÙˆÓ
(“two hit hypothesis”).
H ÂͤÏÈÍË Ù˘ Ë·ÙÔÛÙ¿وÛ˘ Û ÛÙ·ÙÔË·-
Ù›Ùȉ· Èı·ÓÔÏÔÁÂ›Ù·È fiÙÈ ÔÊ›ÏÂÙ·È ÛÙÔ˘˜ Ì˯·ÓÈ-
ÛÌÔ‡˜ Ù˘ ‰Â‡ÙÂÚ˘ Ê¿Û˘ Ù˘ «˘fiıÂÛ˘ ÙˆÓ ‰‡Ô
¯Ù˘ËÌ¿ÙˆÓ». OÈ Ì˯·ÓÈÛÌÔ› ·˘ÙÔ› ÂÚÈÏ·Ì‚¿-
ÓÔ˘Ó ÁÂÓÂÙÈÎÔ‡˜, ÂÚÈ‚·ÏÏÔÓÙÈÎÔ‡˜ Î·È ‰È·ÈÙËÙÈ-
ÎÔ‡˜ ·Ú¿ÁÔÓÙ˜, ÙËÓ ·‡ÍËÛË ÙÔ˘ TGF-‚ Î·È ¿Ï-
ÏˆÓ Î˘ÙÙ·ÚÔÎÈÓÒÓ Î·È ÙÂÏÈο ÙËÓ ÂÓÂÚÁÔÔ›ËÛË
ÙÔ˘ ηٷÚÚ¿ÎÙË Ù˘ ‰ËÌÈÔ˘ÚÁ›·˜ ÈÓÒ‰Ô˘˜ ÈÛÙÔ‡
Ô˘ Ô‰ËÁ› ÛÙËÓ Î›ÚÚˆÛË. °È·Ù› Û ÔÚÈṲ̂ÓÔ˘˜ ·Ó-
ıÚÒÔ˘˜ —Ô˘ ¤¯Ô˘Ó Ë·ÙÔÛÙ¿وÛË— Û˘Ì‚·›-
ÓÂÈ Î·È Ë Ê¿ÛË ÙÔ˘ ‰Â‡ÙÂÚÔ˘ ¯Ù˘‹Ì·ÙÔ˜ Ì ·Ô-
Ù¤ÏÂÛÌ· ÙË ÛÙ·ÙÔË·Ù›Ùȉ·, ÂÓÒ Û ¿ÏÏÔ˘˜ ‰ÂÓ
·Ú·ÙËÚ›ٷÈ, ‰ÂÓ Â›Ó·È ÂÓÙÂÏÒ˜ ÂÍ·ÎÚÈ‚ˆÌ¤ÓÔ.
¶ÚfiÛÊ·Ù· ÂÚÈÁÚ¿ÊËΠfiÙÈ Û ÔÈÎÔÁ¤ÓÂȘ ÌÂ
ÚԉȿıÂÛË ÁÈ· ª∞™ ˘¿Ú¯Ô˘Ó ÔÏ˘ÌÔÚÊÈÛÌÔ›
ÛÙÔ ÁÔÓ›‰ÈÔ Ô˘ Έ‰ÈÎÔÔÈ› ÙËÓ ·‰ÈÔÓÂÎÙ›ÓË.
103
 EÏÏËÓÈο ¢È·‚ËÙÔÏÔÁÈο XÚÔÓÈο 21, 2
ÿÛˆ˜ ·˘Ù¿ Ù· ¿ÙÔÌ· ÂÍ·ÈÙ›·˜ Ù˘ ÁÔÓȉȷ΋˜ ·Ï-
Ï·Á‹˜ Ô˘ ¤¯ÂÈ Û˘Ì‚Â› ηı›ÛÙ·ÓÙ·È ÈÔ ÂÈÚÚÂ‹
Û ª∞™28‚.
¶·ıÔÏÔÁÔ·Ó·ÙÔÌÈÎÒ˜ ÛÙËÓ Ë·ÙÔÛÙ¿وÛË
Ê·›ÓÔÓÙ·È ÔÏÏ¿ Ë·ÙÈο ·ÙÙ·Ú· Ó· Â›Ó·È ‰ÈÔ-
ÁΈ̤ӷ Î·È Ó· ÂÚȤ¯Ô˘Ó ÛÙ·ÁÔÓ›‰È· Ï›Ô˘˜ ÛÙÔ
ÚˆÙfiÏ·ÛÌ¿ ÙÔ˘˜ Î·È ÎÂÓÔÙÔÈÒ‰Ë ˘Ú‹Ó· Ô˘
·ˆıÂ›Ù·È ÂÚÈÊÂÚÈο (ballooning hepatocyte
necrosis). OÈ ·ÏÏÔÈÒÛÂȘ ·˘Ù¤˜ Â›Ó·È ÂÌÊ·Ó¤ÛÙÂ-
Ú˜ Á‡Úˆ ·fi Ù· ÊÏ‚›‰È· Î·È ÛÙ· ˘Ï·›· ‰È·ÛÙ‹-
Ì·Ù· (∂ÈÎ. 2)29.
™ÙËÓ ÂÚ›ÙˆÛË Ù˘ ÛÙ·ÙÔË·Ù›Ùȉ·˜ ·-
ÚÔ˘ÛÈ¿˙ÔÓÙ·È, ÂÎÙfi˜ ·fi Ù· ·Ú·¿Óˆ ÛÙÔȯ›·
Ë·ÙÔÛÙ¿وÛ˘, ÂÈÚÔÛı¤Ùˆ˜ Î·È ÛÙÔȯ›· ¯Úfi-
ÓÈ·˜ ÊÏÂÁÌÔÓ‹˜, Ó¤ÎÚˆÛ˘ Î·È ›ÓˆÛ˘. §ÂÌÊÔ·Ù-
Ù·Ú· Î·È ÌÂÁ¿Ï· ÌÔÓÔ‡ÚËÓ· ‰ÈËıÔ‡Ó Ù· ˘Ï·›·
‰È·ÛÙ‹Ì·Ù·. ¶·ÚÔ˘ÛÈ¿˙ÂÙ·È Â›Û˘ ‰È·‚ÚˆÙÈ΋
Ó¤ÎÚˆÛË Î·È Û·ÓÈfiÙÂÚ· Ë ˘·Ï›ÓË Mallory (∂ÈÎ.
3)30. Δ· ۈ̿ÙÈ· Mallory ÂÌÊ·Ó›˙ÔÓÙ·È ˆ˜ ‚ÈÔÏÂÙ›
ÎÔÏÏÒ‰Ë ˘·ÏÔÂȉ‹ ¤ÁÎÏÂÈÛÙ· Ô˘ ‚Ú›ÛÎÔÓÙ·È ÛÙËÓ
ÂÚÈ˘ÚËÓÈ΋ ÂÚÈÔ¯‹ ÙÔ˘ ΢ÙÙ·ÚÔÏ¿ÛÌ·ÙÔ˜ ÙˆÓ
EÈÎ. 2. ªË ·ÏÎÔÔÏÈ΋ Ë·ÙÔÛÙ¿وÛË.
EÈÎ. 3. ªË ·ÏÎÔÔÏÈ΋ ÛÙ·ÙÔË·Ù›Ùȉ·.
104
Ë·ÙÔ΢ÙÙ¿ÚˆÓ. ∞ÔÙÂÏÔ‡ÓÙ·È ·fi ÂÎÊ˘ÏÈṲ̂Ó˜
ÂӉȿÌÂÛ˜ ›Ó˜ (cytokeratin) ÙÔ˘ ΢ÙÙ·ÚÈÎÔ‡ ÛÎÂ-
ÏÂÙÔ‡ ÙˆÓ Ë·ÙÔ΢ÙÙ¿ÚˆÓ Î·È ‰ÚÔ˘Ó ¯ËÌÂÈÔÙ·ÎÙÈ-
ο ÁÈ· Ù· ÔÏ˘ÌÔÚÊÔ‡ÚËÓ·.
πÛÙÔÏÔÁÈÎÒ˜ Ë ÌË ·ÏÎÔÔÏÈ΋ ÛÙ·ÙÔË·Ù›Ùȉ·
Ô˘ ÂÍÂÏ›ÛÛÂÙ·È Û ΛÚÚˆÛË ¯·Ú·ÎÙËÚ›˙ÂÙ·È ·fi
Ë·ÙÔÛÙ¿وÛË, ·ÏÏ¿ Î·È ÔÈΛÏÔ ‚·ıÌfi ÊÏÂÁÌÔ-
Ó‹˜, Ë·ÙÔ΢ÙÙ·ÚÈ΋˜ ‚Ï¿‚˘ Î·È ›ÓˆÛ˘ ÛÙ· ÎÔÏ-
Ò‰Ë ÙÚȯÔÂȉ‹, Ë ÔÔ›· ÌÔÚ› Ó· ÂÍÂÏȯı› ÛÂ
˘Ï·›· ΛÚÚˆÛË (∂ÈÎ. 4)31,32. ™Â ÚÔ¯ˆÚË̤ÓË Î›Ú-
ÚˆÛË ¯¿ÓÔÓÙ·È Ù· ÛÙÔȯ›· Ù˘ Ë·ÙÔÛÙ¿وÛ˘,
ÁÈ’ ·˘Ùfi ÔÏϤ˜ ÂÚÈÙÒÛÂȘ ÎÚ˘„ÈÁÂÓÔ‡˜ ΛÚÚˆ-
Û˘ Â›Ó·È ·ÔÙ¤ÏÂÛÌ· ª∞™ Ô˘ ‰ÂÓ ‰È·ÁÓÒÛıËÎÂ
ÓˆÚ›ÙÂÚ·.
H ÛÙ·‰ÈÔÔ›ËÛË Ù˘ ·ıÔÏÔÁÔ·Ó·ÙÔÌÈ΋˜ ÂÈ-
ÎfiÓ·˜ Ù˘ ÌË ·ÏÎÔÔÏÈ΋˜ ÛÙ·ÙÔË·Ù›Ùȉ·˜ ÚÔÙ¿-
ıËÎÂ, ·Ú¯Èο, Ó· Á›ÓÂÙ·È Û 4 ÛÙ¿‰È·33. ∞ÚÁfiÙÂÚ·
Ô Mendler Î·È Û˘Ó. ÚfiÙÂÈÓ·Ó ÙÚfiÔ ÛÙ·‰ÈÔÔ›Ë-
Û˘ Î·È ÂÎÙ›ÌËÛ˘ Ù˘ ‚·Ú‡ÙËÙ·˜ Ù˘ ª∞™ Û ÙÚ›·
ÛÙ¿‰È·, Ï·Ì‚¿ÓÔÓÙ·˜ ˘fi„Ë Î·È ‚·ıÌÔÏÔÁÒÓÙ·˜
ÙËÓ ˘Ï·›· ›ÓˆÛË (·fi 0-6), ÙË ÏԂȷ΋ ÊÏÂÁÌÔÓ‹
Î·È Ó¤ÎÚˆÛË (·fi 0-3), Ù· ۈ̿ÙÈ· ªallory (·fi
0-3), ÙË ‰ÈfiÁΈÛË ÙˆÓ Î˘ÙÙ¿ÚˆÓ (·fi 0-3), ÙËÓ
ÎÔÏÒ‰Ë ›ÓˆÛË (·fi 0-3) Î·È ÙȘ ÏÈÒ‰ÂȘ ÌÂÙ·‚Ô-
Ϥ˜ (·fi 1-4). ™ÎÔÚ ‰Ú·ÛÙÈÎfiÙËÙ·˜ Â›Ó·È ÙÔ Û‡ÓÔ-
ÏÔ ÙˆÓ ÂÈ̤ÚÔ˘˜ ‚·ıÌÒÓ ÏËÓ ÙˆÓ ÏÈˆ‰ÒÓ ÌÂÙ·-
‚ÔÏÒÓ. O ˘ÔÏÔÁÈÛÌfi˜ Ù˘ ‚·Ú‡ÙËÙ·˜ Ù˘ ª∞™
ÚÔ·ÙÂÈ ˆ˜ ÂÍ‹˜:
™Ù¿‰ÈÔ 1 (˘Ï·›· ›ÓˆÛË 0-2 Î·È ÛÎÔÚ ‰Ú·ÛÙÈ-
ÎfiÙËÙ·˜ 0-4),
™Ù¿‰ÈÔ 2 (˘Ï·›· ›ÓˆÛË 3 Î·È ÛÎÔÚ ‰Ú·ÛÙÈÎfi-
ÙËÙ·˜ 5-7),
™Ù¿‰ÈÔ 3 (˘Ï·›· ›ÓˆÛË 4-6 Î·È ÛÎÔÚ ‰Ú·ÛÙÈ-
ÎfiÙËÙ·˜ 8-12).
OÈ Û˘ÁÁÚ·Ê›˜ ıˆÚÔ‡Ó fiÙÈ Ì ÙÔ Û‡ÛÙËÌ· ·˘-
EÈÎ. 4. ªË ·ÏÎÔÔÏÈ΋ ÛÙ·ÙÔË·Ù›Ùȉ· Ì ›ÓˆÛË. ªÂ
ÌÏ ¯ÚÒÌ· Ê·›ÓÂÙ·È Ô ÈÓ҉˘ ÈÛÙfi˜.
 EÏÏËÓÈο ¢È·‚ËÙÔÏÔÁÈο XÚÔÓÈο 21, 2
Ùfi ÔÚÈÔıÂÙÂ›Ù·È Î·Ï‡ÙÂÚ· Ë ÛÙ·‰ÈÔÔ›ËÛË Î·È Ë
ÚfiÁÓˆÛË34.
H ÂÈÙÚÔ‹ ÙÔ˘ ÂıÓÈÎÔ‡ ÈÓÛÙÈÙÔ‡ÙÔ˘ ˘Á›·˜
ÙˆÓ ∏¶∞ ÁÈ· ÙË ÌË ·ÏÎÔÔÏÈ΋ ÛÙ·ÙÔË·Ù›Ùȉ·
ÚfiÙÂÈÓ Â›Û˘ ¤Ó· Û‡ÛÙËÌ· ‚·ıÌÒÓ ·ÔÙÂÏÔ‡-
ÌÂÓÔ ·fi 14 ÈÛÙÔÏÔÁÈο ¯·Ú·ÎÙËÚÈÛÙÈο. ªÂ ‚¿ÛË
ÙÔ ÛÎÔÚ ‰Ú·ÛÙÈÎfiÙËÙ·˜ ÌÔÚ› Ó· Á›ÓÂÈ ‰È¿ÎÚÈÛË
Û ÌË ·ÏÎÔÔÏÈ΋ ÛÙ·ÙÔË·Ù›Ùȉ·, Û ÔÚȷ΋ η-
Ù¿ÛÙ·ÛË Î·È Û ·ÚÓËÙÈÎfi ·ÔÙ¤ÏÂÛÌ· ÁÈ· ÛÙ·-
ÙÔË·Ù›Ùȉ·35.
øÛÙfiÛÔ, ˘¿Ú¯ÂÈ ÌÂÁ¿ÏË ÌÂÙ·‚ÏËÙfiÙËÙ· Ù˘
ÂÎÙ›ÌËÛ˘ ÙˆÓ ÈÛÙÔÏÔÁÈÎÒÓ Â˘ÚËÌ¿ÙˆÓ ÌÂٷ͇
‰È·ÊfiÚˆÓ ·ıÔÏÔÁÔ·Ó·ÙfïÓ. Δ·‡ÙÈÛË ÂÎÙ›ÌËÛ˘
‰È·ÈÛÙÒıËΠÌfiÓÔ ÛÙÔ 61%1.
ΔÔ ÔÛÔÛÙfi Ù˘ ÌÂÙ¿ÙˆÛ˘ Ù˘ ÛÙ·ÙÔË·Ù›-
Ùȉ·˜ Û ΛÚÚˆÛË Â›Ó·È ‰‡ÛÎÔÏÔ Ó· ÂÎÙÈÌËı› ¯ˆ-
Ú›˜ ‚ÈÔ„›·, ÂÎÙfi˜ ·Ó ¤¯ÂÈ ‹‰Ë ‰ËÌÈÔ˘ÚÁËı› ΛÚÚˆ-
ÛË Ì Ì›ˆÛË ÙˆÓ ÂÎÎÚÈÙÈÎÒÓ ÏÂÈÙÔ˘ÚÁÈÒÓ ÙÔ˘ ‹-
·ÙÔ˜ (·Ú¿Ù·ÛË ¯ÚfiÓÔ˘ ÚÔıÚÔÌ‚›Ó˘, Ì›ˆÛË
ÏÂ˘ÎˆÌ·Ù›Ó˘). ™Â ÌÂϤÙË ‚ÈÔ„ÈÒÓ 132 ·ÛıÂÓÒÓ
Ì ÌË ·ÏÎÔÔÏÈ΋ ÏÈÒ‰Ë ÓfiÛÔ ÙÔ˘ ‹·ÙÔ˜, 21,2%
›¯·Ó ÚÔ¯ˆÚË̤ÓË ›ÓˆÛË ‹ ΛÚÚˆÛË. ∏ ·‡ÍËÛË
Ù˘ Û¯¤Û˘ SGOT/SGPT Î·È Ë ÂÎʇÏÈÛË Î˘ÙÙ¿ÚˆÓ
Ì ·ÒıËÛË ÙÔ˘ ˘Ú‹Ó· Û¯ÂÙ›˙ÔÓÙ·Ó Ì ÙËÓ ÂÚÈ-
˘Ï·›· ›ÓˆÛË36.
Δ· ¿ÙÔÌ· Ì ª∞§¡∏ ¤¯Ô˘Ó Û˘¯Ó¿ ·˘ÍË̤ӷ
Â›‰· Ûȉ‹ÚÔ˘ Î·È ÊÂÚÚÈÙ›Ó˘. ¢ÂÓ ‚Ú¤ıËÎÂ Û˘-
Û¯¤ÙÈÛË Ì ÙÔÓ Û›‰ËÚÔ ‹ ÙË ÊÂÚÚÈÙ›ÓË ÚÔ˜ ÙËÓ Âͤ-
ÏÈÍË ÚÔ˜ ÛÙ·ÙÔË·Ù›Ùȉ· Î·È ›ÓˆÛË (‚Ï. Î·È ·-
ڷοو). ™Â ÔÛÔÛÙfi 71% ÔÈ ·ÛıÂÓ›˜ Ì ª∞™
Î·È 50% ÔÈ ·ÛıÂÓ›˜ Ì ª∞∏ ›¯·Ó ÂÓ·Ôı¤ÛÂȘ
Ûȉ‹ÚÔ˘ ÛÙÔ ‹·Ú37.
∫ÏÈÓÈ΋ ÂÈÎfiÓ·. OÈ ·ÛıÂÓ›˜ Ì ª∞§¡∏ Û˘-
Ó‹ıˆ˜ Â›Ó·È ·Û˘Ìو̷ÙÈÎÔ› ‹ ÌÔÚ› Ó· ·ÈÛı¿ÓÔ-
ÓÙ·È ¤Ó· ·›ÛıËÌ· ‚¿ÚÔ˘˜ ÛÙÔ ‰ÂÍÈfi ¿Óˆ ÙÂÙ·ÚÙË-
ÌfiÚÈÔ Ù˘ ÎÔÈÏ›·˜. ∂›Û˘ ÌÔÚ› Ó· ·Ú·ÔÓÔ‡-
ÓÙ·È ÁÈ· ‡ÎÔÏË ÎfiˆÛË. H Ê˘ÛÈ΋ ÂͤٷÛË ‰Â›-
¯ÓÂÈ Û˘Ó‹ıˆ˜ ·¯˘Û·ÚΛ·, ÂÓÒ Ë·ÙÔÌÂÁ·Ï›· ‰È·-
ÈÛÙÒÓÂÙ·È ÛÂ ÂÚÈÛÛfiÙÂÚÔ ·fi 50% ÙˆÓ ·ÛıÂ-
ÓÒÓ. ΔÔ ‹·Ú Û˘Ó‹ıˆ˜ Â›Ó·È Ì·Ï·Îfi ‹ Ê˘ÛÈÔÏÔÁÈ-
΋˜ Û˘ÛÙ¿Ûˆ˜. ∏ Ë·ÙÈ΋ ÛÙ¿وÛË ·Ó·Î·Ï‡ÙÂ-
Ù·È Û˘Ó‹ıˆ˜ ·fi ÙË ‰È·›ÛÙˆÛË ·˘ÍËÌ¤ÓˆÓ ÙÚ·Ó-
Û·ÌÈÓ·ÛÒÓ Î·È Á-GT ‹ ·fi ˘ÂÚ˯ÔÁÚ¿ÊËÌ· ÛÂ
·ÛıÂÓ›˜ Ô˘ ‰ÂÓ ›ÓÔ˘Ó ÔÈÓÔÓÂ˘Ì·ÙÒ‰Ë ÔÙ¿.
À„ËÏÔ‡ ÎÈÓ‰‡ÓÔ˘ ÁÈ· Ë·ÙÈ΋ ÛÙ¿وÛË Â›Ó·È Ù·
‰È·‚ËÙÈο, Ù· ·¯‡Û·Úη, Ù· ‰˘ÛÏÈȉ·ÈÌÈο ηÈ
Ù· ˘ÂÚÙ·ÛÈο ¿ÙÔÌ·. ∞Ó ˘¿Ú¯ÂÈ ÛÙ·ÙÔË·Ù›ÙÈ-
‰· Ì ›ÓˆÛË, ÙÔ ‹·Ú Á›ÓÂÙ·È ÙÂÏÈο ÛÎÏËÚfiÙÂÚÔ
Î·È ÌÂÁ·Ï‡ÙÂÚÔ. OÈ ·ÛıÂÓ›˜ Ô˘ ¤¯Ô˘Ó ÛÙ·ÙÔË-
·Ù›Ùȉ· Ë ÔÔ›· ÂÍÂÏ›¯ıËΠ۠ΛÚÚˆÛË ÂÌÊ·Ó›-
˙Ô˘Ó Î·È Ù· ÎÏÈÓÈο Â˘Ú‹Ì·Ù· Ù˘ ÎÈÚÚÒÛˆ˜ (ÎÚ˘-
„ÈÁÂÓ‹˜ ΛÚÚˆÛË).
∂ÚÁ·ÛÙËÚȷ΋ ‰È¿ÁÓˆÛË. ™ÙËÓ Ë·ÙÔÛÙ¿و-
ÛË ÔÈ ÂÚÁ·ÛÙËÚȷΤ˜ ÂÍÂÙ¿ÛÂȘ ÙÔ˘ ‹·ÙÔ˜ ÌÔÚ›
Ó· Â›Ó·È Ê˘ÛÈÔÏÔÁÈΤ˜, ÂÓÒ Û ÌÂÚÈΤ˜ ÂÚÈÙÒÛÂȘ
Â›Ó·È ÂÏ·ÊÚÒ˜ ·ıÔÏÔÁÈΤ˜. MÔÚ› Ó· ˘¿Ú¯ÂÈ
ÌÂÌÔӈ̤ÓË ·‡ÍËÛË ÙˆÓ ÙÚ·ÓÛ·ÌÈÓ·ÛÒÓ, Ù˘ ·Ïη-
ÏÈ΋˜ ʈÛÊ·Ù¿Û˘, Ù˘ Á- GT ‹ Û˘Ó‰˘·Ṳ̂ÓË ·‡ÍË-
ÛË ·˘ÙÒÓ. ŸÙ·Ó Â›Ó·È ·˘ÍË̤Ó˜ ÔÈ ÙÚ·ÓÛ·ÌÈÓ¿Û˜,
Ë SGPT ˘ÂÚ¤¯ÂÈ Ù˘ SGOT, ÂÓÒ ÙÔ ·ÓÙ›ıÂÙÔ Û˘Ì-
‚·›ÓÂÈ ÛÙËÓ ·ÏÎÔÔÏÈ΋ ÓfiÛÔ ÙÔ˘ ‹·ÙÔ˜ Î·È ÛÙËÓ
ÚÔ¯ˆÚË̤ÓË ÛÙ·ÙÔË·Ù›Ùȉ· Ô˘ ¤¯ÂÈ ·ÚÎÂÙ‹
›ÓˆÛË. H ¯ÔÏËÛÙÂÚ›ÓË Î·È Ù· ÙÚÈÁÏ˘ÎÂÚ›‰È· ÌÔÚ›
Ó· Â›Ó·È ·˘ÍË̤ӷ. H ÊÂÚÚÈÙ›ÓË Â›Ó·È ·˘ÍË̤ÓË ÛÂ
ÙÔ˘Ï¿¯ÈÛÙÔÓ 50% ÙˆÓ ÂÚÈÙÒÛˆÓ.
¶·Ú¿ ÙËÓ ·ÓÙÈÏËÙ‹ ‰ÈfiÁΈÛË ÙÔ˘ ‹·ÙÔ˜,
·‡ÍËÛË ÙˆÓ Ë·ÙÈÎÒÓ ÂÓ˙‡ÌˆÓ ‰È·ÈÛÙÒÓÂÙ·È ÛÂ
ÌÈÎÚfi ÔÛÔÛÙfi ·ÛıÂÓÒÓ. ™Â ÌÂϤÙË Ù˘ Û˘¯ÓfiÙË-
Ù·˜ ·Ó‡ÚÂÛ˘ ·˘ÍËÌ¤ÓˆÓ Ë·ÙÈÎÒÓ ÂÓ˙‡ÌˆÓ Ô˘
¤ÁÈÓ Û ·ÛıÂÓ›˜ Ì ™¢ Ù‡Ô˘ 2, ‚ڋηÌ ÌÂٷ͇
1.247 ·ÛıÂÓÒÓ ·˘ÍË̤ӷ ¤Ó˙˘Ì· Û 39 ·ÛıÂÓ›˜
(2,85%). ™ÙÔ˘˜ 23 ·ÛıÂÓ›˜ Ë ·ÈÙ›· ÙˆÓ ·˘ÍË̤ӈÓ
ÂÓ˙‡ÌˆÓ ‹Ù·Ó Ë ª∞§¡∏. ™ÙÔ˘˜ 6 ·ÛıÂÓ›˜ ‚Ú¤-
ıËΠ¯ÔÏÔÏÈı›·ÛË, Û ¤Ó·Ó ηÚΛÓÔ˜, Û 4 ·ÛıÂ-
Ó›˜ ¯ÚfiÓÈ· ÂÓÂÚÁfi˜ Ë·Ù›Ùȉ· B Î·È Û ¤Ó·Ó ·ÛıÂ-
Ó‹ Ë·Ù›Ùȉ· C38. B¤‚·È· ·Ó Ë ·Ó·˙‹ÙËÛË ª∞§-
¡∏ Û ¿ÙÔÌ· Ì ™¢ Ù‡Ô˘ 2 Á›ÓÂÈ Ì ‚ÈÔ„›·, ÛÙÂ-
¿ÙˆÛË ‹ Î·È ÛÙ·ÙÔË·Ù›Ùȉ· ı· ‰È·ÈÛÙÒÓÔÓÙ·Ó
Û Ôχ ÌÂÁ·Ï‡ÙÂÚÔ ÔÛÔÛÙfi Ô˘ ÊÙ¿ÓÂÈ ÙÔ 50%-
80%10. ¢ËÏ·‰‹, ÂÓÒ ÌÔÚ› Ó· ˘¿Ú¯ÂÈ ·ıÔÏÔÁÔ-
·Ó·ÙÔÌÈÎÒ˜ ª∞§¡∏, ‰ÂÓ ˘Ê›ÛÙ·ÓÙ·È ¿ÓÙÔÙ ·-
ıÔÏÔÁÈο ‚ÈÔ¯ËÌÈο Â˘Ú‹Ì·Ù·6.
™ÙȘ ∏¶∞, Ô˘ Â›Ó·È ÌÈ· ¯ÒÚ· Ì ȉȷ›ÙÂÚ·
˘„ËÏfi ÔÛÔÛÙfi ·¯˘Û¿ÚΈÓ, Ë ÌË ·ÏÎÔÔÏÈ΋ ÛÙÂ-
·ÙÔË·Ù›Ùȉ· ÚÔÛ‚¿ÏÏÂÈ 2%-5% ÙˆÓ Î·ÙԛΈÓ.
™Â Ôχ ÌÂÁ·Ï‡ÙÂÚÔ ÔÛÔÛÙfi (15%-20%) ˘¿Ú¯ÂÈ
·Ï‹ Ë·ÙÔÛÙ¿وÛË.
™ÙËÓ ·Ï‹ ª∞∏ ÔÈ ÙÚ·ÓÛ·ÌÈÓ¿Û˜ ÌÔÚ› Ó·
Â›Ó·È Ê˘ÛÈÔÏÔÁÈΤ˜ ‹ ÂÏ·ÊÚÒ˜ ·˘ÍË̤Ó˜, Ì ۯ¤-
ÛË SGOT/SGPT <1. ™ÙËÓ ÚÔ¯ˆÚË̤ÓË ª∞™ ÔÈ
ÙÚ·ÓÛ·ÌÈÓ¿Û˜ Â›Ó·È ·˘ÍË̤Ó˜ Û 90% ÙˆÓ ·ÛıÂ-
ÓÒÓ, Ì SGOT/SGPT >1. H ·ÏηÏÈ΋ ʈÛÊ·Ù¿ÛË
Â›Ó·È ·˘ÍË̤ÓË ÏÈÁfiÙÂÚÔ Û˘¯Ó¿, ÂÓÒ Û·Ó›ˆ˜ ›ӷÈ
·˘ÍË̤ÓË Ë ¯ÔÏÂÚ˘ıÚ›ÓË. ∞ÚÎÂÙ¿ Û˘¯Ófi ‡ÚËÌ·
Û ª∞§¡∏, fiˆ˜ ‹‰Ë ·Ó·Ê¤ÚıËÎÂ, Â›Ó·È Ë ·˘ÍË-
̤ÓË ÊÂÚÚÈÙ›ÓË. ∏ ·‡ÍËÛË Ù˘ ÊÂÚÚÈÙ›Ó˘ ‰ÂÓ ¤¯ÂÈ
ÂȉÈ΋ Û˘Û¯¤ÙÈÛË Ì ÙËÓ ÂͤÏÈÍË Û ÛÙ·ÙÔË·Ù›ÙÈ-
‰·. ŸÌˆ˜ ȉȷ›ÙÂÚ· ·˘ÍË̤ÓË ÊÂÚÚÈÙ›ÓË Ê·›ÓÂÙ·È
·ÚÎÂÙ¿ Èı·Ófi Ó· Â›Ó·È ‰Â›ÎÙ˘ ÛÙ·ÙÔË·Ù›ÙÈ-
‰·˜39. ∂Âȉ‹ Ë ›‰È· ÂÚ›Ô˘ ÂÚÁ·ÛÙËÚȷ΋ ÂÈÎfiÓ·
—‚ÈÔ¯ËÌÈ΋ Î·È ·ÂÈÎÔÓÈÛÙÈ΋— ˘¿Ú¯ÂÈ ÛÙËÓ
Ë·ÙÔÛÙ¿وÛË Î·È ÛÙË ÛÙ·ÙÔË·Ù›Ùȉ·, ÌfiÓÔ Ë
105
 EÏÏËÓÈο ¢È·‚ËÙÔÏÔÁÈο XÚÔÓÈο 21, 2
‚ÈÔ„›· ÌÔÚ› Ó· ı¤ÛË ÙË ‰È¿ÁÓˆÛË Ù˘ ÛÙ·ÙÔË-
·Ù›Ùȉ·˜ Ì ÙË ‰È·›ÛÙˆÛË ÙˆÓ ÂÈÚfiÛıÂÙˆÓ
ÛÙÔȯ›ˆÓ ÊÏÂÁÌÔÓ‹˜ Î·È ÂӉ¯Ô̤ӈ˜ ›ÓˆÛ˘10.
H ÁÂÓÈ΋ ‰È¿ÁÓˆÛË Ù˘ ª∞§¡∏ Ù›ıÂÙ·È Ì ÙÔ
˘ÂÚ˯ÔÁÚ¿ÊËÌ· (Ï·ÌÚfi, ʈÙÂÈÓfi ‹·Ú) Ô˘
¤¯ÂÈ Â˘·ÈÛıËÛ›· 89% Î·È ÂȉÈÎfiÙËÙ· 93%. ∏ ·ÍÔ-
ÓÈ΋ ÙÔÌÔÁÚ·Ê›· ‰Â›¯ÓÂÈ Â›Û˘ ÙË Û˘ÛÛÒÚ¢ÛË
ÙÔ˘ Ï›Ô˘˜, ·ÏÏ¿ Â›Ó·È ÂͤٷÛË ‰Â‡ÙÂÚ˘ ÂÈÏÔÁ‹˜.
H ÈÔ ·ÎÚÈ‚‹˜, ·ÏÏ¿ Î·È ·ÎÚÈ‚‹, ÌË ÂÂÌ‚·ÙÈ΋
̤ıÔ‰Ô˜ Â›Ó·È Ë Ì·ÁÓËÙÈ΋ Ê·ÛÌ·ÙÔÛÎÔ›· (ªRI
spectroscopy) Ô˘ ÌÔÚ› Ó· ÚÔÛʤÚÂÈ ÏËÚÔÊÔ-
ڛ˜ Î·È ÁÈ· ÙËÓ ÔÛÔÙÈ΋ ÂȂ‚·›ˆÛË Ù˘ Ë·ÙÔ-
ÛÙ¿وÛ˘, ·ÏÏ¿ ¯ÚËÛÈÌÔÔÈÂ›Ù·È Î˘Ú›ˆ˜ Û ÂÚ¢-
ÓËÙÈο ÚˆÙfiÎÔÏÏ·40,41.
H ·Ó¿ÁÎË ‚ÈÔ„›·˜ ‹·ÙÔ˜ ÁÈ· ÙË ‰È¿ÁÓˆÛË
ª∞§¡∏ Â›Ó·È ·ÓÙÈΛÌÂÓÔ ·ÓÙÈÚÚ‹ÛˆÓ. OÈ ·ÓÙÈ-
ÙÈı¤ÌÂÓÔÈ ˘ÔÛÙËÚ›˙Ô˘Ó fiÙÈ Ë ÓfiÛÔ˜ Â›Ó·È Û˘Ó‹ıˆ˜
ηÏÔ‹ı˘, fiÙÈ ‰ÂÓ ˘¿Ú¯ÂÈ ‰È·ÊÔÚÂÙÈ΋ ıÂÚ·›·
ª∞∏ Î·È ª∞™, ÂÓÒ Ì ÙË ‚ÈÔ„›· ÚÔÛÙ›ıÂÙ·È Ô
ÂÂÌ‚·ÙÈÎfi˜ ΛӉ˘ÓÔ˜ Î·È ÙÔ ÎfiÛÙÔ˜ Ù˘7.
øÛÙfiÛÔ, Ë ‚ÈÔ„›· ÙÔ˘ ‹·ÙÔ˜ ÂÓ‰¤¯ÂÙ·È Ó·
οÓÂÈ ÈÔ ÂÈı·Ú¯ÈÎfi ÙÔÓ ·ÛıÂÓ‹ ÛÙÔ ‰È·ÈÙÔÏfiÁÈÔ
Î·È ÙË Ê·Ú̷΢ÙÈ΋ ıÂÚ·›· Ô˘ ı· ‰Ôı›. ∂È-
ϤÔÓ ÌfiÓÔ Ë ‚ÈÔ„›· ÌÔÚ› Ó· Û˘Ì‚¿ÏÂÈ ÛÙËÓ
ÂÎÙ›ÌËÛË Ù˘ ‚·Ú‡ÙËÙ·˜ Ù˘ ‚Ï¿‚˘ Î·È Ó· ı¤ÛÂÈ
ÙËÓ ÚfiÁÓˆÛË, ·Ó ˘¿Ú¯ÂÈ ‰ËÏ·‰‹ ÛÙ·ÙÔË·Ù›ÙÈ-
‰· Î·È ›ÓˆÛË10,33,35.
H ‰È¿ÁÓˆÛË Ù˘ ª∞§¡∏, ˆ˜ ·ÔÙÂϤÛÌ·ÙÔ˜
‰È·‚ËÙÈ΋˜ Ë·ÙÔ¿ıÂÈ·˜, Á›ÓÂÙ·È ·ÊÔ‡ ·ÔÎÏÂÈ-
ÛÙÔ‡Ó ¿ÏϘ ·Èٛ˜ ÏÈÒ‰Ô˘˜ ‹·ÙÔ˜, fiˆ˜ Â›Ó·È Ô
·ÏÎÔÔÏÈÛÌfi˜, Ë ‚·ÚÈ¿ ‰˘ÛÏÈȉ·ÈÌ›·, Ë ˘ÂÚ‚ÔÏÈ-
΋ ·¯˘Û·ÚΛ· Î·È Ë ¯ÚfiÓÈ· ‰ËÏËÙËÚ›·ÛË ·fi
ÙËÙÈο ÂÙÚÔ¯ËÌÈο, ÔÈ ¯ÚfiÓȘ Ë·Ù›Ùȉ˜ B ηÈ
C, Ë ·˘ÙÔ¿ÓÔÛË Ë·Ù›Ùȉ·, Ë ·ÈÌԯڈ̿وÛË, Ë
ÓfiÛÔ˜ ÙÔ˘ Wilson Î·È Ë ¤ÏÏÂÈ„Ë ·1-·ÓÙÈıÚ˘„›-
Ó˘42. ™ÙÔ ‰È¿¯˘ÙÔ ÏÈ҉˜ ‹·Ú ÙÔ ˘ÂÚ˯ÔÁÚ¿-
ÊËÌ· ‰›ÓÂÈ ÙËÓ ÂÈÎfiÓ· ÙÔ˘ Ï·ÌÚÔ‡-ʈÙÂÈÓÔ‡ ‹·-
ÙÔ˜, ÁÈ·Ù› ˘¿Ú¯ÂÈ ¤ÓÙÔÓË Ë¯ÔÁ¤ÓÂÈ·. ™ÙËÓ ·ÍÔÓÈ΋
ÙÔÌÔÁÚ·Ê›· Ë ¿ıÚÔÈÛË ÙÔ˘ Ï›Ô˘˜ ÛÙÔ Ë·ÙÈÎfi ·-
Ú¤Á¯˘Ì· ÌÂÈÒÓÂÈ ÙËÓ ˘ÎÓfiÙËÙ¿ ÙÔ˘ Î·È ‰›‰ÂÙ·È
ÛÎÔÙÂÈÓfiÙÂÚË ÂÈÎfiÓ·. AÓ ÙÔ Ï›Ô˜ Â›Ó·È Û˘ÁÎÂ-
ÓÙڈ̤ÓÔ Î·Ù¿ ÂÚÈÔ¯¤˜, ‰›‰ÂÙ·È Ë ÂÈÎfiÓ· ÙÔ˘
„¢‰ÔfiÁÎÔ˘. ∞˘Ù‹ Ë ÂÛÙȷ΋ ¿ıÚÔÈÛË Ï›Ô˘˜ ÌÂÈ-
ÒÓÂÙ·È Ì ÙËÓ Â›Ù¢ÍË Â˘ÁÏ˘Î·ÈÌ›·˜ Î·È Ì ‰›·ÈÙ·
·‰˘Ó·Ù›ÛÌ·ÙÔ˜43.
¶ÚfiÁÓˆÛË. H ÚfiÁÓˆÛË Ù˘ ª∞∏ Â›Ó·È Û˘-
Ó‹ıˆ˜ ηϋ Î·È ÛÙËÓ ÏÂÈÔÓfiÙËÙ· ÙˆÓ ÂÚÈÙÒÛÂ-
ˆÓ ‰ÂÓ ·Ú·ÙËÚÂ›Ù·È ÂͤÏÈÍË Û ÛÙ·ÙÔË·Ù›Ùȉ·,
›ÓˆÛË Î·È Î›ÚÚˆÛË ‹·ÙÔ˜. ¢ÂÓ ÌÔÚԇ̠ӷ Ô‡-
Ì fï˜ ÙÔ ›‰ÈÔ Î·È ÁÈ· ÙË ª∞™, ÛÙËÓ ÔÔ›· ÂͤÏÈ-
Í‹ Ù˘ Û ›ÓˆÛË Î·È Î›ÚÚˆÛË ·Ú·ÙËÚÂ›Ù·È Û ÛË-
106
Ì·ÓÙÈÎfi ÔÛÔÛÙfi (20%-50%)44,45. ™Â Ôχ ÌÈÎÚfi
ÔÛÔÛÙfi Ë ÌË ·ÏÎÔÔÏÈ΋ ÛÙ·ÙÔË·Ù›Ùȉ· ÌÔÚ›
Ó· ÂÍÂÏȯı› Û ηÚΛӈ̷ ÙÔ˘ ‹·ÙÔ˜. ΔÔ ÔÛÔ-
ÛÙfi Ù˘ ÌÂÙ¿ÙˆÛ˘ Ù˘ ΛÚÚˆÛ˘ Û ηÚΛÓÔ ‹·-
ÙÔ˜ Â›Ó·È Û¯ÂÙÈο ÌÈÎÚfi Î·È ÂÓÙ¿ÛÛÂÙ·È ÛÙÔ ÔÛÔ-
ÛÙfi Ù˘ ηÚÎÈÓÈ΋˜ ÙÚÔ‹˜ Ù˘ ΛÚÚˆÛ˘ ÁÂÓÈο.
∞fi 420 ·ÛıÂÓ›˜ Ì ª∞§¡∏ ÌfiÓÔ ‰‡Ô ¿ÙÔ-
Ì· ÂÌÊ¿ÓÈÛ·Ó Ë·ÙÔ΢ÙÙ·ÚÈÎfi ηÚΛÓÔ, ÔÛÔÛÙfi
Ô˘ Â›Ó·È ÌÈÎÚfiÙÂÚÔ ·fi ÙÔ ·Ó·ÌÂÓfiÌÂÓÔ Ó· Û˘Ì-
‚› ÁÈ· ÙËÓ Ë·Ù›Ùȉ· μ Î·È C46.
O Sheth Î·È Û˘Ó., Û˘Ó‰˘¿˙ÔÓÙ·˜ Ù· ·ÔÙÂϤ-
ÛÌ·Ù· ÙÚÈÒÓ ÌÂÏÂÙÒÓ, ˘ÔÏfiÁÈÛ·Ó ·fi ¤Ó· Û‡ÓÔÏÔ
28 ·ÛıÂÓÒÓ Ì ÌË ·ÏÎÔÔÏÈ΋ ÛÙ·ÙÔË·Ù›Ùȉ· fiÙÈ
Û ¯ÚÔÓÈÎfi ‰È¿ÛÙËÌ· 1-7 ÂÙÒÓ 3% ·˘ÙÒÓ ‚ÂÏÙÈÒ-
ıËÎÂ, 54% ·Ú¤ÌÂÈÓ ÛÙËÓ ›‰È· ηٿÛÙ·ÛË, ÂÓÒ
43% ÂÍÂÏ›¯ıËΠ۠‚·Ú‡ÙÂÚË Î·Ù¿ÛÙ·ÛË. ™Â Ô-
ÛÔÛÙfi 8%-17% ÙˆÓ ·ÛıÂÓÒÓ ·Ú·ÙËÚ‹ıËΠÂͤÏÈ-
ÍË ÚÔ˜ ΛÚÚˆÛË, ÂÓÒ Ù· ·ÓÙ›ÛÙÔȯ· ÔÛÔÛÙ¿ ÁÈ·
ÙËÓ ·ÏÎÔÔÏÈ΋ Ë·Ù›Ùȉ· Â›Ó·È 38%-50%. °ÂÓÈο
ÌÔÚ› Ó· ϯı› fiÙÈ ¤Ó·˜ ÛÙÔ˘˜ ¤ÍÈ ·ÛıÂÓ›˜ Ì ÌË
·ÏÎÔÔÏÈ΋ ÛÙ·ÙÔË·Ù›Ùȉ· ı· ηٷϋÍÂÈ Û ΛÚ-
ÚˆÛË47.
™Â Ù¤ÛÛÂÚȘ Û¯ÂÙÈο ÚfiÛÊ·Ù˜ ÌÂϤÙ˜ Âͤ-
ÏÈ͢ Ù˘ ª∞§¡∏ Û ›ÓˆÛË, ·Ó ˘ÔÏÔÁÈÛÙÔ‡Ó Û˘-
ÁÎÂÓÙÚˆÙÈο Ù· ·ÔÙÂϤÛÌ·Ù· ·fi 217 ·ÛıÂÓ›˜,
‚ÂÏÙ›ˆÛË ·ÚÔ˘Û›·Û·Ó ·ÛıÂÓ›˜ Û ÔÛÔÛÙfi
22,5%, ÛÙ·ıÂÚ‹ ηٿÛÙ·ÛË 40,09% Î·È ¯ÂÈÚÔÙ¤-
Ú¢ÛË 37,32%48-51. ™Â ¿ÏÏË ·Ó·ÛÎfiËÛË ·Ó·Ê¤ÚÂ-
Ù·È fiÙÈ, Û ÛÂÈÚ¿ ¤ÓÙ ‰ËÌÔÛȇÛÂˆÓ Ì ª∞§¡∏
Ô˘ ˘Ô‚Ï‹ıËÎ·Ó Û ‚ÈÔ„›Â˜ ‹·ÙÔ˜ ·ÛıÂÓÒÓ ÌÂ
ª∞™ Î·È ·Ú·ÎÔÏÔ‡ıËÛË 3,5 ¤ˆ˜ 11 ¯ÚfiÓÈ· (‚ÈÔ-
„›· Û 54 ·ÛıÂÓ›˜ ·fi 257), 28% ÂÍÂÏ›¯ıËÎ·Ó ÛÂ
Ë·ÙÈ΋ ‚Ï¿‚Ë, 59% ‰ÂÓ ÂÍÂÏ›¯ıËÎ·Ó Î·È 13%
‚ÂÏÙÈÒıËηÓ52.
O ı¿Ó·ÙÔ˜ ÙˆÓ ·ÙfiÌˆÓ Ô˘ ¤¯Ô˘Ó ª∞™ ÌÔ-
Ú› Ó· Â¤ÏıÂÈ ˆ˜ Û˘Ó¤ÂÈ· Ù˘ ÎÈÚÚÒÛˆ˜ ‹ ¿Ï-
ÏˆÓ ·ıÔÏÔÁÈÎÒÓ Î·Ù·ÛÙ¿ÛÂˆÓ Ô˘ Û˘Ì·ÚÔÌ·Ú-
ÙÔ‡Ó (ÓfiÛÔ˜ ÛÙÂÊ·ÓÈ·›ˆÓ ·ÚÙËÚÈÒÓ, ·ÚÙËÚȷ΋
˘¤ÚÙ·ÛË, ‰È·‚‹Ù˘).
ø˜ ÚÔ˜ ÙÔ ÚÔÛ‰fiÎÈÌÔ ÂÈ‚›ˆÛ˘, ˘ÔÏÔÁ›-
ÛıËΠfiÙÈ ÂÈ‚›ˆÛË 5 Î·È 10 ÂÙÒÓ Â›¯Â ÙÔ 67% ηÈ
59% ·ÓÙ›ÛÙÔȯ· ÙˆÓ ·ÛıÂÓÒÓ Ì ª∞™. Δ· ·ÓÙ›-
ÛÙÔȯ· ÔÛÔÛÙ¿ ÁÈ· ÙËÓ ·ÏÎÔÔÏÈ΋ Ë·Ù›Ùȉ· ›ӷÈ
Ôχ ¯ÂÈÚfiÙÂÚ· ‹ÙÔÈ 38% ÛÙ· 5 ¯ÚfiÓÈ· Î·È 15%
ÛÙ· 10 ¯ÚfiÓÈ·53.
£ÂÚ·›·. H Ú‡ıÌÈÛË ÙÔ˘ ‰È·‚‹ÙË ‰ÂÓ ÂÏ·Ù-
ÙÒÓÂÈ ÙÔ Ï›Ô˜ ·fi ÙÔ ‹·Ú, ÂÓÒ ÙÔ ÂÏ·ÙÙÒÓÂÈ Ë ‰›-
·ÈÙ· ·‰˘Ó·Ù›ÛÌ·ÙÔ˜ Ì Ì›ˆÛË ÙÔ˘ Ï›Ô˘˜ Î·È ÙˆÓ
˘‰·Ù·ÓıÚ¿ÎˆÓ Ù˘ ÙÚÔÊ‹˜. ∂ÈϤÔÓ ‚ÂÏÙ›ˆÛË
ÚÔÛʤÚÔ˘Ó Ë Ì›ˆÛË ÙÔ˘ ۈ̷ÙÈÎÔ‡ ‚¿ÚÔ˘˜ ÛÂ
Û˘Ó‰˘·ÛÌfi Ì ·‡ÍËÛË Ù˘ ۈ̷ÙÈ΋˜ ‰Ú·ÛÙËÚÈfi-
 EÏÏËÓÈο ¢È·‚ËÙÔÏÔÁÈο XÚÔÓÈο 21, 2
ÙËÙ·˜54-56. 줂·È· Ë ·‡ÍËÛË Ù˘ ۈ̷ÙÈ΋˜ ‰Ú·-
ÛÙËÚÈfiÙËÙ·˜ ‚ÂÏÙÈÒÓÂÈ Î˘Ú›ˆ˜ ÙËÓ ·ÓÙ›ÛÙ·ÛË ÛÙËÓ
ÈÓÛÔ˘Ï›ÓË ÛÙÔ Ì˘˚Îfi Û‡ÛÙËÌ· Î·È fi¯È ÛÙÔ ‹·Ú,
fï˜ ÂÌ̤ۈ˜ Û˘Ì‚¿ÏÏÂÈ ÛÙËÓ ·ÒÏÂÈ· ‚¿ÚÔ˘˜
Î·È ÙË ‚ÂÏÙ›ˆÛË Ù˘ ‰˘ÛÏÈȉ·ÈÌ›·˜.
ΔÔ ·ÔÙ¤ÏÂÛÌ· Ù˘ ·ÒÏÂÈ·˜ ‚¿ÚÔ˘˜ ÛÙËÓ
ÈÛÙÔÏÔÁÈ΋ ÂÈÎfiÓ· Ù˘ ÛÙ·ÙÔË·Ù›Ùȉ·˜ ÔÈΛÏÏÂÈ,
‰Â‰Ô̤ÓÔ˘ fiÙÈ Ì Ôχ Ù·¯Â›· ·ÒÏÂÈ· ‚¿ÚÔ˘˜ ·-
Ú·ÙËÚÂ›Ù·È ¯ÂÈÚÔÙ¤Ú¢ÛË57, ÂÓÒ Ì ‚Ú·‰Â›· ·Ò-
ÏÂÈ· ‚¿ÚÔ˘˜ ‚ÂÏÙ›ˆÛË18. ¶ÂÚÈÁÚ¿ÊÂÙ·È fiÙÈ ÌÂÙ¿
·fi ˘ÁÈÂÈÓԉȷÈÙËÙÈο ̤ÙÚ· Ô˘ ÂÈʤÚÔ˘Ó ‚Ú·-
‰Â›· ·ÒÏÂÈ· ‚¿ÚÔ˘˜ (›ÛË ‹ ÌÈÎÚfiÙÂÚË ·fi 1,5 Kg
/‚‰ÔÌ¿‰·) ·Ú·ÙËÚÂ›Ù·È ‚ÂÏÙ›ˆÛË fi¯È ÌfiÓÔ Ù˘
ÊÏÂÁÌÔÓ‹˜ ·ÏÏ¿ Î·È Ù˘ ›ÓˆÛ˘58. πÛÙÔÏÔÁÈ΋ ‚ÂÏ-
Ù›ˆÛË ÂÚÈÁÚ¿ÊËÎÂ Î·È Û 4 ·fi 5 ·ÛıÂÓ›˜ Ô˘
˘Ô‚Ï‹ıËÎ·Ó Û ϛ·Ó ˘ÔıÂÚÌȉÈ΋ ÎÂÙÔÁÂÓ‹ ‰›·È-
Ù· Ì 20 g ˘‰·Ù¿ÓıڷΘ ËÌÂÚËÛ›ˆ˜. ∏ ‰È·ÊÔÚ¿
ÛÙËÓ ›ÓˆÛË ¤‰ÂÈÍ ÛÙ·ÙÈÛÙÈ΋ Ù¿ÛË (trend) ‚ÂÏÙ›ˆ-
Û˘ (p<0,07)59¶.
øÛÙfiÛÔ, ¯ÚÂÈ¿˙ÂÙ·È ÚÔÛÔ¯‹ ÛÙË ÌÂÁ¿ÏË Ù·-
¯‡ÙËÙ· ·ÒÏÂÈ·˜ ‚¿ÚÔ˘˜, ÁÈ·Ù› Ù· ΢ÎÏÔÊÔÚÔ‡ÓÙ·
∂§O ·fi ÙËÓ ·˘ÍË̤ÓË ÏÈfiÏ˘ÛË ÌÔÚ› Ó· ÂÓ·-
ÔÙ›ıÂÓÙ·È ÛÙÔ ‹·Ú Î·È Ó· ·˘Í¿ÓÔ˘Ó ÙË ‰È‹ıËÛË
Ì ϛÔ˜59. ¢È¿ÊÔÚ· Ê¿Ú̷η ¤¯Ô˘Ó ‰ÔÎÈÌ·ÛÙ›
Û ÌÈÎÚfi ·ÚÈıÌfi ·ÛıÂÓÒÓ Î·È Ù· ·ÔÙÂϤÛÌ·Ù¿
ÙÔ˘˜ ·Ú·Ù›ıÂÓÙ·È ·Ú·Î¿Ùˆ:
μÈÙ·Ì›ÓË ∂. ™ÙȘ ¯ÚfiÓȘ ·ı‹ÛÂȘ ÙÔ˘ ‹·ÙÔ˜
·Ú·ÙËÚÂ›Ù·È ÌÂȈ̤ÓË ÈηÓfiÙËÙ· ÂÍÔ˘‰ÂÙ¤ÚˆÛ˘
ÙÔ˘ ÔÍÂȉˆÙÈÎÔ‡ stress. H ‚ÈÙ·Ì›ÓË ∂ ÌÂÈÒÓÂÙ·È ÛÂ
fiϘ ÙȘ Ë·ÙÈΤ˜ ·ı‹ÛÂȘ, ÁÈ’ ·˘Ùfi Î·È ¯ÔÚËÁ‹-
ıËΠ‰ÔÎÈÌ·ÛÙÈο ÛÙË ıÂÚ·›· Ù˘ ª∞§¡∏. ∞Ó
Î·È Û οÔȘ ÌÂϤÙ˜ ˘‹ÚÍ·Ó ÂÓı·ÚÚ˘ÓÙÈο
·ÔÙÂϤÛÌ·Ù· ·fi ÙË ¯ÔÚ‹ÁËÛ‹ Ù˘, ‰ÂÓ ıˆÚ›-
Ù·È fiÙÈ ˘¿Ú¯Ô˘Ó ·ÎfiÌË ÂÈÛÙÈο ıÂÙÈο ·ÔÙÂϤ-
ÛÌ·Ù· Î·È ÁÈ’ ·˘Ùfi ··ÈÙÔ‡ÓÙ·È ÚÔ˜ ÙÔ‡ÙÔ ÌÂÁ·-
χÙÂÚ˜ Î·È Î·Ï¿ ÂÏÂÁ¯fiÌÂÓ˜ ÔÏ˘ÎÂÓÙÚÈΤ˜ ÌÂ-
ϤÙ˜60,61.
ÃÔÏÈο Ôͤ·. ΔÔ Ô˘ÚÛÔ‰ÂÛÔ͢¯ÔÏÈÎfi Ô͇ ¤¯ÂÈ
¯ÚËÛÈÌÔÔÈËı› Î·È ÛÙË ıÂÚ·›· Ù˘ ª∞™, ·ÏÏ¿
Ù· ·ÔÙÂϤÛÌ·Ù· Ù˘ ÔÌ¿‰·˜ ÛÙËÓ ÔÔ›· ÔÈ ·ÛıÂ-
Ó›˜ ‹Ú·Ó 13 ‹ 15 mg/Kg μ™ ËÌÂÚËÛ›ˆ˜ ÙÔ˘ Ê·Ú-
Ì¿ÎÔ˘ ‰ÂÓ ‰È¤ÊÂÚ·Ó ÌÂÙ¿ ·fi ‰‡Ô ¯ÚfiÓÈ· ·fi ·˘-
Ù¿ Ù˘ ÔÌ¿‰·˜ ÙÔ˘ ÂÈÎÔÓÈÎÔ‡ Ê·ÚÌ¿ÎÔ˘ (Ë ÌÂϤÙË
ÂÚÈÂÏ¿Ì‚·ÓÂ Î·È ‚ÈÔ„›Â˜ ‹·ÙÔ˜)62.
º¿Ú̷η-¢·ÈÛıËÙÔÔÈËÙ¤˜ ÛÙËÓ ÈÓÛÔ˘Ï›ÓË.
º¿Ú̷η Ô˘ ¢·ÈÛıËÙÔÔÈÔ‡Ó ÙÔ˘˜ ÈÛÙÔ‡˜ ÛÙË
‰Ú¿ÛË Ù˘ ÈÓÛÔ˘Ï›Ó˘ Ê·›ÓÂÙ·È Ó· ¤¯Ô˘Ó ¢ÓÔ˚΋
Â›‰Ú·ÛË Ì ‚ÈÔ¯ËÌÈο ÎÚÈÙ‹ÚÈ·, ·ÏÏ¿ ‰ÂÓ ‚Ú¤ıË-
Π¿ÓÙÔÙ ‰È·ÊÔÚ¿ ÛÙËÓ ¿ıÚÔÈÛË ÙÔ˘ Ï›Ô˘˜ ηÈ
ÛÙËÓ ›ÓˆÛË ÙÔ˘ ‹·ÙÔ˜63. ™Â Ì›· ηϿ ۯ‰ȷṲ̂ÓË
ÈÙ·ÏÈ΋ ÌÂϤÙË Ë ÌÂÙÊÔÚÌ›ÓË Â¤‰Ú·Û ÂˆÊÂÏÒ˜
ÌÂÈÒÓÔÓÙ·˜ ÙȘ ÙÚ·ÓÛ·ÌÈÓ¿Û˜, ÙËÓ ¿ıÚÔÈÛË ÙÔ˘ Ï›-
Ô˘˜ Î·È ÙËÓ ›ÓˆÛË64. ∏ ÚÔÛÈÁÏÈÙ·˙fiÓË Ê¿ÓËΠ·Ô-
ÙÂÏÂÛÌ·ÙÈ΋ ÛÙË Ì›ˆÛË ÙˆÓ Ë·ÙÈÎÒÓ ÂÓ˙‡ÌˆÓ ̤-
¯ÚÈ Ù· Ê˘ÛÈÔÏÔÁÈο fiÚÈ·, ÛÙÔ 1/3 ÙˆÓ ÂÚÈÙÒÛˆÓ
Ô˘ ¯ÔÚËÁ‹ıËÎÂ65. ™Â ¿ÏÏË ÌÂϤÙË Ì ÙË ÚÔÛÈÁÏÈÙ·-
˙fiÓË ‚Ú¤ıËΠ‚ÂÏÙ›ˆÛË ˆ˜ ÚÔ˜ ÙË Û˘ÛÛÒÚ¢ÛË Ï›-
Ô˘˜ ÛÙ· Ë·ÙÈο ·ÙÙ·Ú· Î·È ÈÛÙÔÏÔÁÈ΋ ‚ÂÏÙ›ˆÛË
ÛÙ· 2/3 ÙˆÓ ÂÚÈÙÒÛÂˆÓ —ÌÂٷ͇ 18 ·ÛıÂÓÒÓ—
‡ÛÙÂÚ· ·fi ıÂÚ·›· 48 ‚‰ÔÌ¿‰ˆÓ.66 ªÂ›ˆÛË ÙˆÓ
·˘ÍËÌ¤ÓˆÓ ÂÈ¤‰ˆÓ Ù˘ SGPT ·Ú·ÙËÚ‹ıËΠηÈ
‡ÛÙÂÚ· ·fi ¯ÔÚ‹ÁËÛË 15 mg ÈÔÁÏÈÙ·˙fiÓ˘ Û 7 ÌÂ-
ٷ͇ 12 ·ÛıÂÓÒÓ Ì MA™67.
™Â 13 ·ÛıÂÓ›˜ Ô˘ ·Ú·ÎÔÏÔ˘ı‹ıËÎ·Ó Â›
48 ‚‰ÔÌ¿‰Â˜ ‡ÛÙÂÚ· ·fi ÙË ‰È·ÎÔ‹ Ù˘ ¯ÔÚË-
ÁÔ‡ÌÂÓ˘ ÈÔÁÏÈÙ·˙fiÓ˘ Ì ‚ÈÔ„›Â˜ Ê¿ÓËΠ·‡ÍË-
ÛË ÙÔ˘ Ï›Ô˘˜ ÙˆÓ Ë·ÙÔ΢ÙÙ¿ÚˆÓ Î·È Ù˘ SGPT,
ÂÓÒ ÂÏ·ÙÙÒıËÎÂ Ë ÏÈÔÓÂÎÙ›ÓË Î·È ·˘Í‹ıËΠË
·ÓÙ›ÛÙ·ÛË ÛÙËÓ ÈÓÛÔ˘Ï›ÓË68.
øÛÙfiÛÔ, ÁÈ· ÙȘ ÁÏÈÙ·˙fiÓ˜ ‰ÂÓ Ú¤ÂÈ Ó· ÏË-
ÛÌÔÓÂ›Ù·È fiÙÈ ·˘Í¿ÓÔ˘Ó ÙÔ ‚¿ÚÔ˜ ÙˆÓ ·ÛıÂÓÒÓ Î·È
˘¿Ú¯Ô˘Ó ÛÔ‚·Ú¤˜ ÂӉ›ÍÂȘ ÁÈ· ÚfiÎÏËÛË ‹ ÂÈ-
‰Â›ÓˆÛË Î·Ú‰È·Î‹˜ ·ÓÂ¿ÚÎÂÈ·˜ Î·È ÂÔ̤ӈ˜
ÂÓ¤¯Ô˘Ó Úfi‚ÏËÌ· ÌÂȈ̤Ó˘ ·ÛÊ¿ÏÂÈ·˜.69
º¿Ú̷η ηٿ Ù˘ ·¯˘Û·ÚΛ·˜ Î·È ˘ÔÏÈ-
ȉ·ÈÌÈο. ¡¤Â˜ Ê·Ú̷΢ÙÈΤ˜ Ô˘Û›Â˜, fiˆ˜ ›-
Ó·È ÔÈ ÂÎÏÂÎÙÈÎÔ› ·ÔÎÏÂÈÛÙ¤˜ ÙˆÓ ÂÓ‰ÔÁÂÓÒÓ Î·-
Ó·‚ÔÂȉÒÓ (Ê¿Ú̷η ηٿ Ù˘ ·¯˘Û·ÚΛ·˜), ›-
Ó·È Â›Û˘ ˘fi ¤Ú¢ӷ. ¢˘ÛÙ˘¯Ò˜, ‰ÂÓ ˘¿Ú¯Ô˘Ó
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̿ΈÓ, ηıÒ˜ Î·È ÔÈ· Â›Ó·È Ë Â›‰Ú·Û‹ ÙÔ˘˜ ÛÙËÓ
ÈÛÙÔÏÔÁ›· ÙÔ˘ ÏÈÒ‰Ô˘˜ ‹·ÙÔ˜70. ™Â Ì›· ·ÓÔȯً
ÌÂϤÙË ·Ú·Ù‹ÚËÛ˘ ıÂÙÈο ·ÔÙÂϤÛÌ·Ù· ¤‰ÂÈ-
Í·Ó ¯ÔÚËÁ‹ÛÂȘ ˆ-3 ÏÈ·ÚÒÓ ÔͤˆÓ Û ¿ÙÔÌ· ÌÂ
·˘ÍË̤ӷ ÙÚÈÁÏ˘ÎÂÚ›‰È·, ·ÙÔÚ‚·ÛÙ·Ù›Ó˘ Û ˘ÂÚ-
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Û·Úη ¿ÙÔÌ·71. ™Â ·ÚfiÌÔÈ· ÌÂϤÙË ¯ÔÚ‹ÁËÛ˘
ηٿ ÂÚ›ÙˆÛË ·ÙÔÚ‚·ÛÙ·Ù›Ó˘, ÊÂÓÔÊÈÌÚ¿Ù˘
‹ Û˘Ó‰˘·ÛÌÔ‡ ÙÔ˘˜ Û ¿ÙÔÌ· Ì ÏÈ҉˜ ‹·Ú ηÈ
‰È¿ÁÓˆÛË ÌÂÙ·‚ÔÏÈÎÔ‡ Û˘Ó‰ÚfiÌÔ˘, ·Ú·ÙËÚ‹ıËÎÂ
‚ÂÏÙ›ˆÛË ÛÙËÓ ˘ÂÚ˯ÔÁÚ·ÊÈ΋ ÂÈÎfiÓ· Î·È Ù·
Ë·ÙÈο ¤Ó˙˘Ì· (67% ˘fi ·ÙÔÚ‚·ÛÙ·Ù›ÓË, 42%
˘fi Ê·ÈÓÔÊÈÌÚ¿ÙË Î·È 70% ÛÂ Û˘Ó‰˘·Ṳ̂ÓË ıÂ-
Ú·›·)72.
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¯ÏˆÚ›‰·. ¶ÚÔ‚ÈÔÙÈο Ê¿Ú̷η Ê·›ÓÂÙ·È fiÙÈ ÂË-
Ú¿˙Ô˘Ó ÙËÓ ÂÓÙÂÚÈ΋ ¯ÏˆÚ›‰· ηٿ ÙÚfiÔÓ Ô˘
¢ÓÔ› ÙËÓ ÂÏ¿ÙÙˆÛË ÙÔ˘ Ï›Ô˘˜ ÙˆÓ Ë·ÙÔ΢ÙÙ¿-
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ÙÈο ·ÔÙÂϤÛÌ·Ù·73.
∞ÓÙÈÌÂÙÒÈÛË Ì¤Ûˆ ÂÏ·ÙÙÒÛˆ˜ Ù˘ ÊÂÚÚÈ-
107
 EÏÏËÓÈο ¢È·‚ËÙÔÏÔÁÈο XÚÔÓÈο 21, 2
Ù›Ó˘. Œ¯Ô˘Ó ‰ÔÎÈÌ·ÛÙ› Î·È ·Ê·ÈÌ¿ÍÂȘ Û ¿ÙÔ-
Ì· Ì ª∞™ Î·È ˘„ËÏ‹ ÊÂÚÚÈÙ›ÓË Î·È Ê¿ÓËΠ‚ÂÏ-
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ª∞§¡∏ ·Ó·Ê¤ÚÂÙ·È fiÙÈ ‰ÂÓ ˘¿Ú¯Ô˘Ó ÂÏÂÁ¯fiÌÂ-
Ó˜ ÌÂϤÙ˜ Ì ηϋ ÙÂÎÌËÚ›ˆÛË Ô˘ Ó· ‰Â›¯ÓÔ˘Ó
‚ÂÏÙ›ˆÛË Ì οÔÈ· Ê·Ú̷΢ÙÈ΋ ıÂÚ·›·75.
¶ÂÈÚ·Ì·ÙÈΤ˜ ıÂÚ·›˜. Œ¯ÂÈ ¯ÔÚËÁËı› ÛÂ
ÔÓÙ›ÎÈ· ÌÂÈÔÓÂÎÙÈο Û ÏÂÙ›ÓË, ηıÒ˜ Î·È Û ·-
¯‡Û·Úη ÛÈÙÈÔÁÂÓÒ˜ ÔÓÙ›ÎÈ·, ¤Ó· ÔÏÈÁÔÓÔ˘ÎÏÂÔ-
Ù›‰ÈÔ ÂÓ·ÓÙ›ÔÓ Ù˘ ÚˆÙ½Ó˘ ‰È·ÊÔÚÔÔ›ËÛ˘ ÛÙ·-
ÁÔÓȉ›ˆÓ Ï›Ô˘˜ ÛÙ· Ë·ÙÔ·ÙÙ·Ú· Î·È ÂÈÙ‡¯ıË-
Π̛ˆÛË Ù˘ Ë·ÙÈ΋˜ Û˘ÛÛÒÚ¢Û˘ Ï›Ô˘˜76.
™˘ÌÂÚ·ÛÌ·ÙÈο, Ô ™¢ Î·È Ë ·¯˘Û·ÚΛ· ›-
Ó·È Û‹ÌÂÚ· ÔÈ ÈÔ Û˘¯Ó¤˜ ·Èٛ˜ Ë·ÙÔ¿ıÂÈ·˜
ÛÙÔÓ ·ÓÂÙ˘Á̤ÓÔ ÎfiÛÌÔ77. ∏ ·‡ÍËÛË Ù˘ Û˘¯Ófi-
ÙËÙ·˜ Ù˘ ·¯˘Û·ÚΛ·˜ Î·È ÙÔ˘ ™¢ Ù‡Ô˘ 2 Ô˘ ·-
Ú·ÙËÚÂ›Ù·È ·ÁÎÔÛÌ›ˆ˜ Â›Ó·È ·ÈÙ›· Ô˘ ı· Ô‰ËÁ‹-
ÛÂÈ Û ·‡ÍËÛË ÙˆÓ ÂÚÈÙÒÛÂˆÓ ª∞§¡∏. ∏ Â-
Ê·ÚÌÔÁ‹ ‰›·ÈÙ·˜ ·‰˘Ó·Ù›ÛÌ·ÙÔ˜ Î·È ¿ÛÎËÛ˘,
ÂÊfiÛÔÓ ÂÊ·ÚÌÔÛÙÔ‡Ó, Â›Ó·È Ù· ÌfiÓ· Û›ÁÔ˘Ú· ηÈ
·ÔÙÂÏÂÛÌ·ÙÈο ̤۷ Ô˘ ÌÔÚ› Ó· ·Ô‰ÒÛÔ˘Ó
ÛÙËÓ ·ÓÙÈÌÂÙÒÈÛË Ù˘ ª∞§¡∏ ÙˆÓ ·¯‡Û·ÚΈÓ
‰È·‚ËÙÈÎÒÓ ·ÙfïÓ. ΔÔ ÁÂÁÔÓfi˜ fiÙÈ Ë ª∞§¡∏ ›-
Ó·È Ë Û˘¯ÓfiÙÂÚË Ë·ÙÈ΋ ÓfiÛÔ˜ Û ¿ÙÔÌ· Ì ™¢ Ù‡-
Ô˘ 2 οÓÂÈ ÂÈÙ·ÎÙÈ΋ ÙËÓ ·Ó¿ÁÎË ÁÈ· Â͇ÚÂÛË
ÌÈ·˜ ·ÔÙÂÏÂÛÌ·ÙÈ΋˜ ıÂÚ·›·˜ —¤Ú·Ó ÙˆÓ
˘ÁÈÂÈÓԉȷÈÙËÙÈÎÒÓ Ì¤ÙÚˆÓ— Ô˘ ı· ·ÔÙÚ¤„ÂÈ
ÙËÓ ÂͤÏÈÍË Ù˘ Ë·ÙÔÛÙ¿وÛ˘ Û ÛÙ·ÙÔË·Ù›ÙÈ-
‰· ‹ Î·È Ù˘ ÙÂÏÂ˘Ù·›·˜ Û ΛÚÚˆÛË.
Abstract
Karamitsos D.Th., Koliouskas D. Non-alcoholic fat-
ty liver disease. Hellen Diabetol Chron 2008; 2: 101-
110.
Two entities are included under the term of non
alcoholic fatty liver disease (NAFLD): non alcoholic
hepatosteatosis and non alcoholic steatohepatitis.
Diabetes mellitus and obesity are the commonest cau-
ses of NAFLD under the main pathogenetic factor of
insulin resistance. Prerequisite for the diagnosis of
non alcoholic fatty liver disease is the relatively absen-
ce of use of alcohol. Cryptogenic cirrhosis is an evolu-
tion of non alcoholic steatohepatitis. The world wide
increase of obesity and type 2 diabetes mellitus is the
reason for an increase in NAFLD in near future. In
this review epidemiological and pathology items are
presented as well as diagnosis, prognosis, and thera-
peutic suggestions of NAFLD.
108
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§¤ÍÂȘ-ÎÏÂȉȿ:
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110
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Key-words:
Diabetes mellitus
Hepatosteatosis
Steatohepatitis
Liver cirrhosis
Insulin resistance