한국   대만   중국   일본 
????????????? - ????? ?????????????? ?????????????????? ????

?????????????

??????? ??????????????? ?????????????????? ???????.


?????????????
Osteoporosis
????????? ??????? ???????????????
??????? ????????
?.??.??. - 10 M 80. - M 82.
?.??.??. - 9 733.0
?.?.??.? 166710
????????? ?????????? 9385
????????????? 000360
????????? med/1693 ped/1683 pmr/94 pmr/95
????????? ?.? ?????????????
?.??.? D010024
????????????? ???? ????????

????????????? ( Osteoporosis ) ?????? ??????? ??????? ?????? ?????? ???????????? ??? ??????? ????????????? ???? ?????. ??????????????????? ?????? ????????? ???? ???????? (Bone Mineral Density) ?????????, ??????? ????????? ?????????? ????????????????? ??????????. ?????? ????????? ???? ??????????? ???? ?????? (????????) ?????? ???? ???????? ??????????? ??? ???????????. ?????? ?????? ???????? ???????????????? (Dual-energy X-ray absorptiometry) ????????? ??????? ??????? ?????????????? (20 ??????? ??????????? ????????? ??????) ??????? ??????? ???? ???????? 2.5 ??????? ??????? ????????????? ????????? ????? ??? ??????? ????????? (WHO) ???????????? ?????????????????. "??????????? ?????????????" ???? ???? ???? ??????? ???????? ??????? ?????? ???????????? ??????????? [1] . ????????????? ????????? ????????????? ????? ??????????? ??????? ???????????. ?????? ??? ????????????? ??????? ????????????? ???????????????????. ??? ????????????, ??????????? ?????????? ?????????????, ???????? ??????? ????????? ?????????? ?????????. ??????????? ?????? ??????????????????????-??????????? ????????????? (SIOP or GIOP) ???????????????? ???????????????? ????????????????????????? ???? ??????? ???????????? ??????????? ??? ?????????. ????? ??????? ???????? ??????? ???????? ?????? ???????????? ?????????????, ????????? ????? ????????????? ??????? ?????????? ?????? ???????????.

???????? ???? ???????????????? ????????????? ??????? ???????????????? ??????????????? ??????????. ????????????? ???????????????? ??? ???????? ???????????? ???????????????????. ???????? ???? ??????????? ??????????? ??????? ???? ??????? ?????????? ?????? ?????????????????. ??????? ?????????????? ????????? , ???????????? ?? , ???????????????? ??????? ?? ?????????????????. ?????????? ?????? ?????? ???????????? ??????????? ??????? ????? ???????????? ????????????? ?????????????? ?????? ???? ??????? ????????? ??????????? ??????????????. ?????? ????????????? ????? ?????????. ????????? ???????????? ????? ??????????? ??????????????? ????????? ????????????? ?????????.

??????????????? [ ???? ]

??????? "???????????" ??????????????????? ???? ???????? ????????????? ???????????

????????????? ????? ??????? ??????? ???????????????? ????? ???? ?????????????? ????????????????? ????? ???????????????? ??????????? ????????????????. ?????? ????????? ????????? ????????? ???? ????????? ??????????? ????????????? ?????????. 10% ????? ??????? ??????? ?????? ??? ????????? ??????????? ???????????????????? ?????????. 1963 ??? ????? ????????? ????????? ??????? ?????????????????? ??? ???? ????????? ??????? ?? ?????? ????????????? (bone multicellular units; BMUs) ??? ????????? [2] . ??????????? (osteoblast) ??????????????? ????? ??????? ?????????????? ????? ??????? ??????????????? ?????????? ????????????????? (osteoclasts) ????????????? ???????????????? [3] .

???????????????? ??????? ???? ??????? ??? (???????????? ???? ????????????? ????????????? ????????? ??????????? ??????????????), ??????? ??????? ????????????? ????? ??????? ????????????? ???? ????? ???????????? ?????????? ???????? ????? ?????? ????????????? ?????????? ?????? ??????? ?????? ???????????. ???? ?????? ?????? ????????? ???????????????? ??????? ??????????? ??????? ????????? ??????????? [3] . ?????????? ?????????? ????????????? ????????? ??????????? ????????? ????????????????. ?????????? ????????? (?.??. ????????? ????????? ????????????), ????????????? ??????? ????????????? ??????? ????? ???????????? ??????? ?????????. ??? ??????? ??? ????????? ???????????? ????????. ??????? ????????????? ?????? ????????????? ???????????? ??????? ?????????? ??? ???? ????????????? ????????????? ??????? ????????????? ???? ??????? ??????????. ?????????? ????????? ?????? ?????? ??????? ???????????? ????????? ??????? ????????????? ?????????? [3] . ?????????? ????????? ?????? ???????? ??????? ??????? ??????????? ??????? ????? ??????????. ????????? ??????? ????????? ?? ?????????? ?????? ??????? ??????????? ?????? ?????????. ???????? ???????? ??? ???????? ?????????? ??? ???????? ?????????? ??????? ??????? ????????? ????????? ??????????????. ??? ??????????? ????????? ?????????? ???????? ??????????????? ????????????? ??????? ?????????????. ???????????????? ???????????????? ??????????? ???????????? ?????????????? ????????????? ????? ??????????. ??? ??? ???????? ?????? ???? ?????????? ??? ?????????????? [3] .

?? ?????????????? ?????????? ?????? ??????????? ???????? ????. ?????, ?????????????????? ????? ?????? ??????? ??????? ?????? ???????????????????.

???????? ????????? ?????????? ????? ???????????????????? ????????? ??????????????????????. ????? RANKL ( ???????????????????? ????? κB ????????????? ????? ????????????) ???? ???????????????????? ?????? ?????? ??????????. ???? ????????? ??????????????????? ???? ????????????????? ??????????????????. (?.??. ???????????????? ) ??????? RANK? (???????????????????? ????? κB???? ????? ????????????) ???????????. RANK??? ?????????????????? ???????? ??????????????????? (OPG) RANKL? ???????????. ?????? ????????????? ??????? ???????????? ??????? ?????? ??????????????????. ????? ??????? ??????????? ??????? ?????????????? RANKL, RANK ??????? OPG ??????????????? ??????? ????????? ??????? ??????????. "wnt" ?????? ???? ????? ???????????????????????. ?????, ??? ??????? ????????? ?????????????????????. ??????????????? ??????? ????????????????????? ????? ????????, ??????? ???????????? ????????? ?????????????? ????? ????????????????????. ???? ??????????? ??????? ?????? ??????? ???????? ????????????? ??????????? ??????? ????????? [3] .

???????????? (Trabecular bone) ?????? ????????????? ????? ???????????. ??? ????? ?????????? ??????? ??????????????? ??????????? ????????? ?????????. ????? ??????? ?????? ???????????? ??????? ????????? ???????. ??? ????? ???????????? ??????? ?????????. ???????????????? ???????????????????? ????????? ???????????? ???????????? ???????????? ????????? ??????????? ??????????????? ?????? ??????????. ????? ????????? ???????? ????????? ????????????? ????????? ????????????????? ??????????????. ?????????????? ???????????? ??????????? ??????? ("??????? ??????????"), ???? ???????? ???????????? ?????????? ???????????. ??????? ????????????? ??????? ?????? ???????? ???????? ??????????, ??????? ??????? ????????????? ??????????? ????? ????????? ????????? ??? ?????????????? ??????? ??????? ??????????. ???? ???????? ?????????? ???????????? ????????????????. ?????? ??????????? ??????????????????? ???? ????????? ??????????? ???? ???????? ??????? ?????????????? [4] .

????????? ???????????? [ ???? ]

????????????? (????), ???????????????????? (????) ???????? ???????? ????????????.

????????????????? ???? ??? ??????????? ???????????? ????? . ??????? ??????????? ?????? ??????????? ??????? ??????? ??????????. ????????????????????? ??????? ??????? ?????? ????????. ???????????????? ????????????? ????????????? ???????????????? ????????. ?????? ?????? ??????? ???????? ??????? ????????? ????? ?????????????. ??????? ???????? ??????? ????????? ??????? ???????????? , ???? ??????? , ??????? ??????? ?????????? ???? ?????????? ????????.

??????? ????????? [ ???? ]

?????????? ???????? ?????? ??? , ???????? ???? ??????????? ???????? (radicular pain) (?????? ???????????? ???????????? ???????? ?????????? ???) ???????? ?????????? ?????? ?????????? ???????? ????????????? ???????? ?????? ?????????????? ??????? ???????????????????? ?????? ???????????? ??????????? ("?????? ?????????????") ??????????????. ???? ??????? ?????????? ????, ????? ???????, ???????????? ?????? ???????????? ???????? ??? ?????? ??????? ?????????????????? ??????? ?????????? ???????? [5] .

????? ???????????? ???????? ??????? ?????? ?????????? ???????? ??????????. ?????? ????????????? ?????????????. ????????? ??????? ????????????????? ???????? ????????????? ????????????. ??????? ????? ?????? ????? ????? ??????? ????????? ??????????? ???????????? ??????? ????????? ??????????? ????? ???????? ??????????? ????????????? ????????? ????????????????.

????????? ?????? [ ???? ]

???? ????????? ?????? ??????? ??????????????? ????????????????. ??? ??????????, ??????????? ??????? ??????? ??????? ????????? ???????????? ??????? ??????????. ???? ????????? ?????? ???????????? ???????????: ?????? ???????????? ????????? ????????? (?.??. ??????????, ???????????? ???? ??????????), ?????? ??????????, ????? ????????????? (?.?? ????????????? ????), ?????? ???? ??????? ??????????? (?????? ???????? ???????????? ???????). ?????????????? (????????? ????????? ?????? ?????? ???????? ???? ??????? ???? ??????? ??????????? ???????) ?????? ?????????? ????????? ?????? ???????????????. ??????????????? ?? ????????? ??????????????. ?????, ????? ????? ???????? ?????????????? (????????? ????? ????????), ??????????? ????????? (vasovagal syncope), ?????????? ?????? ???????? (orthostatic hypotension) (??????? ???????? ???? ????????????? ????? ????? ???????? ???????) ??????? ??????????????????? ?????? ????????. ????????? ??????????????????????? ?????????????? ??????? ???????????????????? ?????????? ?????????? ???????????? ?????????? ??????????. ??????? ???? ??????????????? ??? ?????? ?????? ?????????? ?????????????? ??????? ???????? ?????????????? [6] .

???????? ???????? [ ???? ]

????????????? ??????? ??????????? ???????? ???????? ????????????????????? ?????? (????????????) ????????????????????? ????? ?????? ???????? ???????????. ???????? ???????? ????????????? ??? ????????????????? ???????? ??????????? ??????????? ??????????????? ??????????. ??????? ???????????? ???????? ??????? ????????????????. ??????????? ??? ????????????? ??????? ?????????????????? ????????????? ?????? ?????????????. ??? ??????????????? ?????????. ?????? (Caffeine) ?????????????????? ???????? ????? ????? [7] .

???????????? ????????? [ ???? ]

????????????????? ??????? ?????????? ???????? ???????? ???? ???????? (??????? ??????? ?????? ????????????) ??????? ???? ???????; ????????? ????????????? ????? ???????? ?????????? (?????? ?????? ????) ?????????? ??????? ??????? ???? ???????? ?????? ??????? ?????? ????????????? ????????????? ??????????. ?????????? ?????????????? ??????? ????????? ??? ????????????? (????????? ???????????) ??????? ??????????. ????? ??????????????????????? ???????? ?????? ???? ??????? ??????? ????????????? ?????? ????????? ?????????????? ????????????? ??????????? [8] . ??????? ?????????? ????????????? ?????? ????????????? ?????????? ??????? ???????? ??????????????. ??????????????? ????????????????? ??????? ????????????? ???????? ???????????????? ??????? ???????? ??????????????. 25???????? 80 ??????? ??? ?????? ?????????. ????????? 30 ????????????? ????????????? ??????????????? ???????????????? [3] . ??? ????????? ?????????????? ????????? ???? ??????? ????????????? ????????????????? ??????? ????????????? ????? ????????? ????????????????? [9] . ???????? ???????? ???????????? ??????? ???????? ???????? ?????????????? [10] .

???? ????????????? ???????????????????? [ ???? ]

  • ??????? ??????? ??? - ????? ??????? ???? ???????????????????? ????????????? ?????? ????????????. ??????? ??? ?????????????? ??????????. ????? ????????? ??????? ?????????????? (??????????? 3 ????????????? ??????? ????? ??????????????????) [11] , ????????? ???? ?????? ??????? ??? ?????????? ?????? ????????????? [12] .
  • ???????????? ?? ???????? [13] ???????? ???????????? ?? ???? ??????? ????????????? ????????? ??????? ??????? ?????????? [14] . ??????? ??? ???????? ?????? ???? (PTH) ???????? ?????? ???????????? ?? ???????????????? ???????????????? [14] . ??? ???????? ?????? ???? ????????????? ????? ?????????? ??????? ?????? ???????????????. ??? ???????? ?????? ???? ??????? ???? ????????????? ??????????? ??????? ???? ????? 1,25-???????????????????????????? ??????????????? ??????? ???? ?????????????? ????? ??? ?????????? ????? ????????? [14] .
  • ???????? ????????? - ???????? ????????? ??????????????? ??????????? ??????? ????????????????? ?????? ?????? ???????? ???????????? [11] [15] . ?????? ??????????? ?????????? ??????? ????????? ???????, ???? ??? ??????? ??????? ??????? ????????? ?????? ????? ?????? ????????????? ????????????????????. ??????????? ???????? ??????? ???? ?????????? ??????????? [14] .
  • ???? ???? ?????? ???????? - ?????? ??????????????? ???????? ???? ???????????? ???????? ??? ??????? ???????? ??????????????????????? ????????????? [16] .
  • ????????????????? - ?????? ??????? ????????? ?????????????????? ??????? ???????????? ?? ??????? ???????????? ?? ????????? ??????? ?????? ?????????????????? [13] , ???? ???? ?????????? ???? ??????? ??????? ??? ?????? ??????? ???????????????? ??????? ????????????? ????????????? ???????? ????????????? ??????? ????????????????????? ???????????????? [14] .
  • ??????????? ??????????? - ??????????? ??????? ???????? ??????? ???????????? ??????????? ????????????. ????? ????????? ????? ????????????????? ???? ???? ???????????? ??????? ??????? ????? ????????? ?????? [14] . ???? ?????????????? ???? ??????? ????????? ??????? ????? ??????????? ?????? ?????? ??? 1 ?????? 2% ????????? ???????. [ ???????? ???? ] ?????? ????? ??????????? ??????????? ??????????????? ??????? ?????? ????????????. [14]
  • ?????????? ??????????? ?????????- ???? ??????? ???? ??????? ???????????????? ????????? ??????? ????????????. ?????? ???? ????????????? ???? ?????????????? ???????????? ????????????. ?????????? ?????????? ???????????? ???????????? ?????????? ??????? ???????????? ???????? ????????????? ???????????? ?? ?????????????????? ???????????. ??????? ???????? ??????????? ?????????? ?????? ????? ?????? ???? ???????? ????????????? ?????? ?????? ????????. ?????? ????? ??????????? ??? ???????????? ??????? ??????????? ???????? ???????? ????????????????? ?????? ????????????.
  • ??? ????????? ????????? - ?????????, ???? ??????? ??????? ?????????? ??????? ??????? ???????? ?????????????????. ?????????????????? ??????? ??????? ???? ???????? ?????? ???????????? ????????? ???????? ????????????????. ??? ????????? ????????????????? ????????????? ??? ??????? ??????? ???????? ?????? ?????????????. ????????? ?????????????? ????????????? (??????? ???????????????) ???????????. [17]
  • ???? ???????? - ???? ???????? (?? ???? ????????? ?????????? ?????? ??????????) ????????????????? ?????? ????????????? ????? ??? ???????? ????????????????????. [18] ????????? ????????????????? ???????? ??????? ???????? ???????????? ????????? ???? ?????????????? ???????? ??????????? ????? ?????????? ????????????????????. [19]
  • ?????? ? ??????? ????????????? ?????? ?????????????? ??????????????????? ??????? ????????? ???? ???????? ?????. [20]

????????? ??????????????? [ ???? ]

?????????????????? ?? ????????? ??????????????? ????????????????. [21] ?????????? ??????? ???????? ????????? ???????????? ??????????? ?????????? ??????? ?????? ??????????. ???? ?????????? ????????? ????? ?????? ????????? ??????????.

  • ??????? ???? ???????? ??????? ?????? ??????????????? ('??????????? ?????? ?????????? ????? ??????????' ?????????). ???????????????? ???????????? ????????????? ??????????????????? ??????? ?????? ????????????????? ??????? ???? ??????? ???????????? ???????? ????????? ???? ????????. ??? ???? ??????? ????????????? ?????, ????????????? ????????? ????????? ??????? ??????? ?????????? (??????????????? ?????????????????). ???? ??????????????????? ??????????????????? ???? ??????? ?????? ?????? ???? ?? ?????????????? ??????????????????? ?????? ?????????????? ????? ?????????????? ????????????????? ????? ????????.
  • ??????????? ??????????? ????????? ???????? ???? ??????????????? ????????? ??????? ??????????. ??????? ????????????????????, ?????????????? ????????????????????, ??????? ????????????????????, ????????? ??????, ????????? [22] , ????????????? ?????????????? ?????? ??????????????????????? ?????? ???????? ???????? [22] . ??????????? ?????? ?????? ???? ?????????????? ??????????? ??????????????? ??????? ???????????. ????????? ????????? ????????? ??????? (<45 ?????????) ?????? ???????? ?????????????????? ????????????????????? (1 ??????) ??????????. ??????? ???????? ??????? (?????????? ????? ???????????? ????? ???????) ?????? ?????????? ??????? ?????????? ????????????? ?????? ?????? ???? ?????????????? ??????? ??????????. ?????????? ?????????????? ?????????? ??????? ??????????. ???????????????? ????????????? ?????? ??????? ????? ????????????? ????? ???????????????? ?????.
  • ?????????? ????????????? ??????? ?????? ?????????. ???????? ??????????? ?????????????????? [14] , ??? ???????? ????? ???????? [14] , ??????????? [14] , ???????????????, ???????? ???? ??? 1 ??????? 2, [23] ?????????????? ??????? ????????? ?????? ?????? ????????. ???????????? ??????? ????????????? ??????????? ??????? ?????? ??????????. [21]
  • ?????????????????, ?????????? ??????????? [14] ??????? ????????????????? ?????? ??????????????? ?????????????. ??????????? ??????????? ??????? ????? ?????? ????????????? ????????????? ??????????? ?????? ?????????????. ????? ?????? ???? [14] , ???????? ????, ?????????? ???????? ?????????, ????? ???????? [22] ( ??????? ??????????????? ?????, ???????????? ????????? ????? ???????? ?????? ????? ???????) ??????? ???????? ???????? ???? (????????? ????????? ????? ??????) [22] ?????? ????????. ??????? ????????? ??????????????? ????????????? ?????????. ???? ??????? ????????? ?????????? ????????????????????? ????????? ???????/?????? ????????? ?? ?? ???? ????????? ???????????????? ????????????? ?????? ?????????????????. ???? ???????-????????????????? ????????? K ?????? ????????? B12 ???????????? ?????? ??????????? ?????????.
  • ??????? ????? ????? ???????? ??????? ????????????? ????????? ????????????? [22] , ???? ?????????????? [22] , ??????? ???????????????? ??????????? ??????? ?? ?????? ??????? ??????? ?????????????? ????????????? ???? ????? ????? ????????? ?????????????? ????????????? ???????????? ?????? ??????? ??????????. ??? ?????????? ?????? ??? ????????? ???? ???????? ???????????? ????????? (????????? ?????????????????? ????????). ??????? ???????? ??????? ???? ?????? ??????? ??????????????? ?????? ??????????????? ????????????? ?????????.
  • ????????? ?????? ?????????? ??????? ?????????????.
  • ?????????? ??????? ??????????????????? ??????????????????? ????????????????. ????????: ?????? ?????????????? [22] ??????? ???? ??????????? ???????????? , [23] ??????????????? ??????? ?????????????????, ?????? ?????????? [22] , ????? ??????? ????, ????????-???? ???? ??????? ???????? .
  • ?? ??????? ??????????????????? ?????????????????? ????????? ?????????????????.???????? ??????? ???????? ????????????? [22] , ????????? ?????? ?????????????? [22] , ????????? ???? [14] , ??????????????????????, ??????????? ???????? ??????? , ?????????????????? [22] , ?????????-???????? ?????? ?????????????? [22] , ???? ??? ????, ?????????? ?????? ?????????????? , ???? ???? ????????? ??????? ????????? ???? ?????? ????????.
  • ?????? ??????? ????????????? ????????? ????????????? ????????????? ???????? ?????? ??????? ??????????. ??????? ?????????? ???????? ????????? ????? ??? ?????? ?????????????? ?????????. ????????????? ???? ??????? ??????? ??????? ??????????? ???????????????? ???? ???????????????? ??? ??????? ???????????.

??????? ???????????? [ ???? ]

??? ??? ?????????? ???????????????????? ????????????? ???????? ?????? ??????? ??????????. ??????????????? ??????? ??????? ????????? ?????? ??????? ?????????????? ????????????? ??????????. ????? ????????? ???? ?????????????? ???? ??????????? ????? ???????????????.

  • ??????????????????????????? ?????????????????? ????????????-??????????? ????????????? (SIOP) ??????????? - ??????????? ?????????????????????? ?????????????? ??????? ?????????? ????????????????? ???????????????? ??????????. ?????????? ?????????????????????? ?????????? ??????????????? ???????? ???????????? ????????? ??????????????????? ????? ?????????. ???????????????? 30 ?????? ???????????? (7.5???? ??????????????) ??????? ????????????????? ????????????? ????????? ?????? ?????????????? ??????? ???????????????????????? ?????????????????? ??? ?????????? ????????????? ???????????????????????. [24] ??? ???? ?????? ??????? ???? ????????????????? ???? ???? ?????????. [25]
  • ???????????? ???? ???????? , ??????????? ??????? ???? ??? ?????? ???????????? ?????????????? ?????? ????????? ?? ???????? ????????? ?????????????????. [26] [26]
  • ??????????? ????????? ?????? L-???????????? ???? ????????????????? ????????????? ?????????. [21] ???????? ?????? ??????????????????? ?????????? ??????? ??????????.
  • ??????????? ??????????? ???????????? ?? ??????????. ????????????? ?????? ???????????? ????????????????? ????????? ?????????????????, ???????????????? ??????? ???? ?????????????????? ??????????, ??????-???????????????? ??????? ??????????? ???????? ?????????? .
  • ???????????????? - ?????????? ????? ??????? ?????????????????? ??????? ???????? ????? ??????? ??????????. [27] ??????? ?????????? ????????????? (??????? ??????????? ????????) ????? ??????? ?????????????????? ????????????? ????????????? ????? ??????? ?????? ????????? ??????????????. [28]
  • ?????????? ????? ????????????????? - ??????? ?????? ?????????? ???? ?????????? ????????????; ????????? ??????????????? ??? ???????????????? ??????????????. [29] ???????? ???????? ?????????? ?????????????? ???? ??????????????? ???????? ?????????. [21]
  • ??????????????????? (??????? ????????? ????????????????????) - ??????????????? ??????? ???????????????, PPARγ ??????????? ????????????? ????????????? ??????? ??????????????? ?????? ??????? ????????? ????? ??????????????. [30]
  • ???????? ????????? ???????? ????????????? ??????? ??????? ??????????. [21]

???? ?????????/?????????? [ ???? ]

?????? ?????? ???????? ??????????????????? ??????? ?????????? ???????????? ??? ??????? ????????????.
??????????? ?????? ?????? ???????? ?????????????

??????? ???? ?????????? ??????????? ?????? ????????????? ?????????? ???????????????. ?????? ?????? ???????? ???????????????? ??????????? ??????? ???????? ??????? ??????????. ?????? ???????? ??????? ???? ???????????? ???????????? ???????? ???????????????? ???????????????????? ????????????? ????????? ????????? ???????? ????????????? ?????????????? ???????? ??????????. ?????? ????? ??????????? ??????? ??????????? ????? ????????????????. ????????????? ????????? ???????????? ???????????? ??????????? ???? ???? ???? ?????? ?????????? , ?????? ??????????????, ??????????? ???? ??????? ???? ????????? ????????????? ???????? ????????????????.

?????? ?????? ???????? ???????????????? [ ???? ]

????????????? ?????????? ?????????? ?????? ?????? ???????? ???????????????? ???? ?? ?????? ?????????????. ???? ???? ?????????? ??????? ???? ???????? 2.5 ???? ?????? ??? ????????? ??????? ????????? ???? ????????????? ?????????? ????????????. ??? ??? ??-?????? (T-score) ????? ????????????????????????. ??? ??????? ??????? ????????? ?????????? ????????????? ????????? [1] [14] :

  • ??-?????? -1.0 ?????? ???????????? ?????? "??????????"
  • ??-?????? -1.0 ??????? -2.5 ????? ????????? "??????? ??????? ???" (?????? "?????????????") ?????
  • ??-?????? -2.5 ?????? ?????? ???? ????????? ???????????????????.

?????????? ????????????? ????????????? ????????? ???? ("??????????? ???????? ??????? ??????? ??????" ?????? "?????? ???????? ??????? ??????") ???????? ??????????????? ????????????? ??????? ?????? ???????????????? ??? "???????? ?????? ?????????" ????????????? ???? ???????? ?????????????? [1] .

??????????????? ????? ??????? ??????? ????????????? ?????? 50 ?????????? ???? ???? ?????????? ????????????? ?????????? ??????????? ?????? ????? ???????? ?????????????????? ??????? ??????? ??????????????. ??????? ????????? ??????? ???????? ??????????? ??-?????????? ?????? ????-?????? (???? ??????? ??????? ?????? ???? ??????????) ?????????? ????????. ???? ????????? ????????? ????? ??????? ??????? ????????????? ?????? ??????????? ????????????? ?????????? ??????????? ?????? [31] [32] .

???? ???????????? [ ???? ]

??, ?????????? ????????????????? ?????-????? ????

65 ??????? ?????? ???????? ???????? ????? ????????? ??????? ??????????? ????? ??????????? ???????? ????? ???????? ????????? ????????? ???????? (USPSTF) 2002-??? ????? ?????????????? [33] . ?????? ??????? ????????? 60???????? 64 ??????? ??????? ??????? ????? ????? ???????? ????? ???? ???????? ??????????????. ????????? ?????? ??????? ?????????? ??????????? ????? ??????? ???? ????? (??? < 70 ????) ??????? ?????? ?????????? ??????????????????????? ?????? ???????? ???????????. ??????? ??????? ???????????? ?????????? ????? ?????????? ??????? ????? ?????????????? ???? ???????? ???????? ????????? ???????????? ??????? ????????? ?????. ?????????? 60 ????????? 64 ??????? ??????? ?????? ?????????? ???????????????? ???????? ???? ???????? ??????? ??????????? ???????????. ????????????? ?????? ????????? ????? (ORAI) ??????? ???????????? ???????? ?????????? [34] .

?????? ??????????????, 65 ?????? ??????? ?????? ???????????? ???????? ????????? ???????????? 80 ?????? ???????? ??????? ?????? ??????? ?????? ???????????? ???????? ???? ???????????? ????? ????? ???? ?????????? ?????????? ????? ??? ?????-??????????? ????????? ?????????????????? [35] . ??????, ??? ?????? ????????? ?????????? ?????????????? ( ???????????????????? ) ??????????? ?????? ??????????????? ??????? ?????? 300?????? ??????? ?????????? ?????? ??????? ????? ??????? ?????-???? ????????????.

???????? [ ???? ]

????????????????? ???????? ??????????? ?? ??????? ????????????? ???????????. ?????? ????????? ????????????? ?????? ????????????????. ?????? ???? ???????????? ???????????? ??????? ??????????.

?????????? [ ???? ]

????????????????????? ???? ????????????? ??????? ?????????? ?????????????. ???????, ???????????????? ??????? ?????????? ??????? ????? ????? ?????????? 1990????? ???????????????.

????????????????????? [ ???? ]

????????????? ???????????????? ????????????? ?????????????????? ?????????? ???? ???????????? ????? ???? ??????????????. presently ??????? ?????????????? (???????????) ??? ???????? 10 ???? ?????? ??? ??????????? ??????? 70 ???? ????????????????, ????????????? (?????????) ??? ???????? 5 ???? ?????? ??? ??????????? ??????? 35 ???? ???????????????? ???????/?????? ?????????????? (??????) ??????????? ??? ???? ???????????????? ?????? ??????? ??????? ???????????? ??????????????????? ????????????????????? ?????.

??????? ??????????? ??????? ??????? ??????????? ????????????? 5 ???? ???????????? ?????????? ?????????? ???????????????? ???? ??????? ???????? ?????????? 35 (13.9???????? 8.6%) ???????????????, ?????????????????? ??????? ?????? ?????? 3.8 ????????????????? 1.7 ??????????????? ?????????????? ???? ?????? ??????? ?????? ?????? 10.7 ????????????????? 7.6 ?????????? ????????? ????? 2007 ??? ??????? ????????????? ????????? ????? ??????????????. ???? ??????? ????????? ????????? ????????????????????????. 1.9 ??????????????? ?????, ??????????????????????? 9.6% ????????? (????? ????????????? ???????? 13.3% ?? ????????) ???? ???????????? ??????????????. ????? 28 ????? ????????? ???? ????????????????????? [36] .

??????? ?????????????????? ??????????? ??????? ????????? ??????????????????. ?????? ??? ?????? ?????????? ?????? 30 ?????????????? ???? ?????? ??????? ??????? ???????? ?????????????? ????????. ??? ?????????????? ???????? (???????????? ??????) ???????????????, ?????? ????????????? ?????????????????? ??????? ??????? ?????????. ????????? ?????? ????????? ???????? ?????????????????? (??? ??????????? ???????? ????????) ???????????? ?????? ????????? ???????????. ??????? ??? ??????????????????????. ???????????????? (???????????? ??????) ????? ?????????? ?????????????? ????? ????????? ????????? ??????? ???????? ?????????? ????????????. ??? ??????? ??????????? ????? ?????? ????????????????? ???? ???? ???????????????? ???????? ??????? ?????? ?????? ?????????????? [37] . ???? ?????????????, ??????? ??????? ?????????????????? ???????? ??????? ???????????????. ???????? ?????????????? ???????? ??????? ???????? ????????? ??? ?????????? ??????????? ???????? ????? ????????????? ??????? ??????????????????? [38] .

???????????????? [ ???? ]

?????????? ????????????????? ?????????????????? (???????, ?????????? ????? ??? ???????? ?????????? 1?34 ????????????) ??????? ??????? ????????? ?????????. ??? ??? ???????? ?????????? ?????? ?????????? ?????????????? ????????????? ??????? ??????????? ?????????????. ????????????? ???????????????? ????????? (??????? ??????? ?????? ?????????????), ????????? ??????? ????????? ???? ???????? ?????? ??????? ??????????? ????????? ??????? ???????????? ?????? ??????? ?????????????????? ????????????? ????????????? ??????????? ??? ????????? ????????????????????. ????-??? ????????? ????????? ??????????? ??? ?????? ??????????? ?????????????????. ??? ?????????, ??????????????????? ??????? ?????????????? ??????????? ??????? ???????????????? ??????????????? ?????????? ?????????? ????????????????? (????????????? ???? ????????? ???????? ???? ??????? ??????? ??????????????? ????????????????????????). ??????? ????????? ???????? ?????????????? ?????????,?????????? ???? ?????????? ?????? ???? ????????? ???? ????????? ???????? ????????.

?????????????? ????????? [ ???? ]

??????? ?????????????? ????????? ?????? ??? ??????? ??????? ??????????????. "?????? ????????? ??????? ?????? ??????????" ????? ?????????????????? ????????????? ???????????? ???????? ?????????. ??????? ????????? ????????? ?????????????????? ??????? ?????? ?????????? ????????????????????? [39] . ????????????? ?????????????? ????????? ???????????????? ??????????????? ?????????????? ????????????????? ????????????????? ??????????????? ????????? ???????????????.

?????????????? ????????? ??????? 2 ?? ??????? ???? ?????????????? ????????????????????????. ?????????????????? ??????? ??????? ????????????? ???????????? ??????????????? ???????????? ?????????? ?????????? ?????????????????. ????????????????????? ?????????????? ??????????? ?????????? ??????? ???????????. ??????? ????????????? ?????????????????? ?????????????? ??????? ??????? ??????? ???? GI ????????? ?????????? ??? ????????????. ???????? ????? ?????????? ????????????? ?????? ??????? ??????? ????????? ??? ?????????? ???????????????????? [40] . ????? ??????? ?????? ??????? ?????????????????????. ???????? ????????????? ??????? ????? ????? ???????? ????????? ????????????? ??????? ??????????? ?????????? ????? ??? ????????????????. ????????? ???? ????????????? ????????? ????????? ???????? ????????????? (???????) ??????????????? ?????? ?????? ???????? ???????????????? ?????????? ????????????????? [41] ?????????????? ??????? ???? ???????????? ?????????? ??????? ????????? ?????????????? ???????????. ?????????????? ?????????? ????????????? ????????????? ???? ???????? ????? ??????? ?????????? ?????? ???? ???????????? ??????? ?????????. ??? ????????? ???????? ???????????????????? [42] .

?????????????? ??????? ?????????? ??????????? ??????? ?????????? ????????? ??????? ??????????????????. ??????? ?? ????? ??????? ????????? ???????????????????? ????????????? ???????? ????? ????????????? ???????????. ?????????????? ???? ??????? ????????????????????? ??? ?????????????????? ?????????????? ?????????? ????? ??????????? ????????????????? ??????????????. ?????????????????? ????????? ?????????? ?????? ??????????? ?????????? ???????? ?????????????? ?????????????????? ??? ????? ???? ????????? ?????? ?????. [ ???????? ???? ]

?????????????? ???? ??????? ??????????? ??????? ?????????? ?????? ?????????????????? ??????????? ?????????????????? ???????? ????????. ???????????? ????????????? ??????????????????? ????????????????? ???? ?????????????? ?????? ?????????? ?????????. ??????? ?????????????? (???????????) ????? ???????????? ???? ???????? ?????????????? ??????? ???????????? ???????????? ???????? ?????????? ?????????????????. ????? ??????????????? ????? ?????????????? ??? ??????? ?????? ????????????? ????? ???????????? ??????????????. ????? ?????????????? ???????? ????????? ?????????????????? ??????? ????????? ?????????????????????????. [ ???????? ???? ]

???????????????? ????????????????? ???? ????????? ??????? ???????????? ?????????? ???? ??????? ????????? ????????? ??????????????? ???????????????? ??????. ?????????, ??????????? ??????? ????????? ?? ?? ??????? ?????? ????????????? ?????????????????? ???????? ??????????. ????? ????????????? ????????????????? ??? ????????? ???????????????? ??????. ?????? ??????????????? ?????? ????????? ?????????????? ????????. [ ???????? ???? ]

?????? ???? ???????? ??????? [ ???? ]

?????? ?????? ???? ???????? ??????? ???????? ????????????????? ?????????? ?????? ??????????? ??????? ????????. ?????, ???? ?????????, ???? ?????????????? ???? ????????????? ????????? ???? ??? ????????????????????????. ????????? ????????? ??????????? ???????? ????? ??????????? ????????? ?????? ?????? ???? ???????????????????? ?????? ??????? ??????? ??????????? ????????????????????? ??????????.

??????????? ??????? ????????? ?????????? ?????????????? ??????? ??????????????? ?????????? ??????????????? ???????????????? ?????????. ????? 2008 ????? ??? ??????? ??????????? ?????????? ?????? ????????? ?????????????? ??????? ?????? ?????? ???????? ??????? ?????. [23]

??????? ?????? ?????? ???? ????????? (SERM) [ ???? ]

???? ????????? ??????????? ??????? ?????? ?????? ???? ???????? ?????????? ???????????? ?????? ??????? ?????? ?????? ???? ????????? ?????????. ?????????, ??????????? ????????? ???? ??????????? ??????? ????????????? ??????????????? ????? ???? ?????????? ????? ??????? ???? ???????? ?????? ??????????????????????. ?????? ?????? ???? ??????????????? ??????????? ???????? ?????????? ??????? ????????-????????????? ???????? ???????????????? ??? ?????????? ????? ??????????. ???????????? ????? ??? SERM??? ????????????? ????? ??????? ?????????? ?????????? ????????? ?????????????. [43] SERM??? ??????? ????????? ????? ???????? ?????????? ????????????????????. [44]

??????????? [ ???? ]

????????? [ ???? ]

??????? ???????? , ??????? ???????? ??????? ??????? ??????? ??????????? ????????????? ?????????????? ????????? ???????? ??????????. ??? ????????????????? ??? ??????????????? ??????. ???? ??????? ?????? ???????? ????????? ???????????????????? ?????????????? ?????????. ????????????????? ?????? ??????? ???????????????? (?????? ?????????? ?????) ??? ???????? 1,200 ???? ???? ????????? ?????????????????????? ????? ???????? ??????? ????????????? ??????????????????????. ??????????? ??????????????????? ????? ?????? ????????? ?????????????. ???? ????????? ?? ????? (500 ???? ?????? ???????? ???????) ????????????? ???????????????????? ????????????? ???????????????? [45] . ?????????, ????????????????? ???????????? ?????????????? ????????????? ????? ??????? ??????????? ? ??????? ??????? ????????? ?????????????????????????? ??????? ???????? ??????? ??????? ??????? ??????????. ???? ??????? ???? ????????? ????? ??????? ??????????? ???????????????????????? ??????? ?????? ??????? ??????????? ??????????. ???? ?????????, ?????? , ????? ??????? ???????????? ?? ????????????????????, ??????????? ??????? ????? ??? ???????? ???????? ???? ??????? ????????????? ?????????????? ????????? ?? ?????????? ??????????????? ??? ????????????????. ??? ??????? ???? ???????????? ??????? ????????????? [46] . 2007-??? ????? ??? ??????? ???????????? (??? ??????? ???????) ??????????? ????????? ??????? ??????? ???????????????????????? ????????????????? ?????????? ???????????? ????? ????????????????????? [47] [48] .

????????? ??????? ?????????????? ????????? ??? ?????????? ??????????? ????????????????? ??????????????????? ?????????? ??? ???????-????????????? ??????? ???????????? (??????? ???????? ????????? ??????? ???????? ?????????) ??????????????? ???? ?????? ?????????????????? ??????? ???????????? ????????? ???????????? ??????????? ????????? (1,200 ???? ?????? ???????? ???????) ??????? ????????? ?? ? (800 IU ?????? ???????? ???????) ???? ???? ?????????????? ?????????. [49] ???????? ??????????????? ???? ??????????? ????????? ?????????? ???????-?????????????? ??????? ??????? ????? ??????? ?????? ????????? ?????????????. [50] ?????? ?????? ????? ??? ???????????? ????????? ???????????? ???? ???????? ??????????????????? (HDL, "?????? ??????? ????????") ????????????????????? ?????????????? 1471 ??????? ?????????? ??? ??????? ????????? ?????? (?????????) ??????????? ???????????? ?????????? ???????????????. ??? ??????????????????, ??????? ??????????? ????????????????????? ??????? ?????? ?????? ???????? ?????? ??? ???? ?????? ???????????? ?????? ??? ????????????????. [51]

????????? ?? [ ???? ]

?????????????? ????????? ??? ???????????????????? ??????? ???????? 1% ?????????????, ??????? ????????????? ??? ?????????????. ????? ???????? ?????? ???????? 17% ?? ????????????? ????? ????????? ??????? ???????? ??????????????????????? ????????? ??? ??????? ???????????????????? ??????????????? ????????????? ????????? ??????????? ????? ??? ???????? ?????????????? [49] [52] [53] .

??????????? [ ???? ]

??????? ????????? ????? ??????????????, ??? ???????? ??????? ???????????? ?????????????? ???? ?????????????? ??????? ??????????? ???????????????? ????????? ???? ?????????? ??????????? ??????????? ???????? ????? ??????? ???????? ??????????????. [54] ????????? ???? ?????????? ??????? ??????? ???????? ???? ?????? ??????? ????????????????? ???? ?????? ?????????????? ??????? ?????????? ?????????? ?????? ?????????????????????? ?? ????????????????? ??????? ?????????. ??????? ??????? ????????? ?????????. ????????????????????? ?????? ??????? ??? ???????????? ?????????? ?????????????? ????????? ?????? ?????????? ????????? ???? ???????? ??????? ????????? ???? ?????????????? [55] ??????? ??????????? ?????? ???????????? ?????????. ?????????? ????????, ??????????????, ??????????, ?????????, ???????????????? ????? ??????? ?????????? ???????????? ?????????????? ???? ??????? ????????????? ????????????????????? ??????????? L2-L4 ????????? ???? ???????????? ??????????????? ?????????? ????????. [56] [57] [58] ????????? ??????, ???? ??????? ??????? ????????? ???? ???????????? ????? ??????? ??????????????? ???????????. [59] ???? ?????????? ???????????? ????? ???? ???????? ??????? ????????????? (HRT) ????????????????? ???????? ??????????? ????????? ???? ???????????? ?????????? ???????????????. ???? ?????????? ?????? ???? ???????? ??????? ???????? ??????? ?????? ??????????? ???????? ???????????????? ??????? ???????????????. [60]

????????????? ????????????? ????????? ???? ?????????? ?????????????????? ???????????? ??????? ???????? ?????????? ???????????, ???????? ???? ??????? ??????? ???????? ???????????. [61]

???? ??????? [ ???? ]

??????? ????????? 1000 ??????-?????????
[62]
WHO ??????? ???? 50-64 ?????????????
???????? 5.3 9.4 6.6
?????????????? 11.4 19.6 15.7
????????????? 22.4 46.6 40.6

??????? ???????? ????????? ???????????? ????????????? ??????????? ????????????? ??????? ???????????, ??????????? ????????? ???????? ??????? ??? ??????? ???? ?????????????.

??????? ??????? ??????????, ?????????? ?????????, ?? ?????????? (????? ???????? ????? ????? ???????/?????? ????????? ??????????? ???????????? , ????????? ?????? ) ????? ??????????? ??????? ??????? ??????? ?????????. ??????? ??????? ?????????? ???????? 6-??? ????????????? ?????? 13.5% ?? ??????????. ??????? ??????? ?????????? ??????????? ????????????? (?????? 13%) ??????? ??????? ?????????? ????? ????????? ??????? ???? ???? ???????????? ???????? ?????????? [63] .

?????????????????? ?????????????????? ?????? ????? ??????? ??????? ??????????? ?????? ???? ?????? ????????????? ???????? ???????? ??? ?????????. ??? ??????????????????? ??????? ?????? ???????????? ?????????????. ?? ?????????????????? ???????????????? ???????? ????????????? ????? (?????????) ?????????????. ??? ??????? ?????? ??????????? ?????? ???????????? ???? ???????? ?????????????? ????????? ???????????? ?????? ????????????.

????????? ??????, ??? ?????????? ??? ????????????? ???????????????? ?????????? ????????????? ?????????? ???????? ??????????? ????????????? ?????????? [64] .

????????????? [ ???? ]

?????????? ?????? ??????? ????????? ????????? ???-??????? ??????????? ???????? ?????????????.

????????? 3?? ????????????, ???????? 12?? ???????????? ???????? 50 ?????? ???????????????? ????????????? ?????????? ????? ???????????????????? [ ???????? ???? ] . ??????????? ????????????? ????????????? ????? ??? ??????? ??????????. ??????????? ?????????? ???????????????, ??????? ??????? ?????????? ????????? ??? ??????????????. ???? ????????? ?????? ???????? ??????? ??????????? ???????? ??????? ??????? ?????????????.

??????? ???????????????? [ ???? ]

????????????????? ??????? ???????? ??????? ??????? ???????????????? ???????????. ????????????? ??????????? 250,000?????? ??????? ??????? ???????????????? ????????????????? ???????????? ???????????. [65] ??? 50 ????????? ????????????? ?????????? 17.5% ??????????? ???? ????????? ?????????????????? ???????? ??????????????? ????? ????????????????????. ?????? ??????? ??????? ???? ???????????? ??????? ?????????????????? ??????? ??????????????? ??????? ??????????? ?????????? ??????????????????. 80 ?????? ???????? ??????? ????????? ???????????? ????????????? ????????? ??????? ???????? ????????????????????????. [66]

?????????????????? ???????????????? [ ???? ]

35-50% ?????????? 50 ??????? ????? ????????????? ????????? ??? ?????????????????? ???????????????? ?????????????????. ????????????? ??????????? 700,000 ?????????????????? ???????????????? ????????????. ????? ???????? ???????? ??? ????? ??????????????????. 68.8 ?????? ??????? 9704 ??????? ?????? 15 ?????????? ??????????? ??????? 324 ??????? ??????? ???????? ???? ?????????????????? ????????????????? ??????????????????????; 18.2% ??????????? ?????????????????? ????????????? ???????? ????? ???? ?????? ??????? ?????????????????? ????????????? ?????? ????????? 41.4% ?? ?????????.

?????????? [ ???? ]

????????????? ??????????? ???????? 250,000 ?????????? ???????????????? ????????????????? ???????????? ???????????. [65] ????????????????? ?????????????????? ????????? ??????? ??????? ??? ?????????? ???????????????? ?????. ??????????? ??????????? ???????? ????????????? ????????????????? ???????? ?????? ?????? 16% ?? ??????????. ??????? 70 ???????? ????????? ?????? 20% ??????????? ????????? ??? ?????????? ???????????????? ?????????????????. [66]

???? ??????? ????????? [ ???? ]

?????? ???? ????????? ???????? ??????? ????????? ??????????? ???????????? ?????????? ????????? ?????????????. ???? ?????? ??????????? ??????? ?????????????????????? ??????????????. ??????????? ????????????? ???????????? ??????? ???????????????????? ?????????????? ????????????????? ?????????? ????? ???? ???????????????? ???????????????????. ???????? ???? ??????? ?????? ???? ???????? ???????? ???? ??????????? ?????????. ??????? ????????????? ?????????? ???????? ???? ????????? ?????? ?????????????? ???????? ???????? ???????? ???? ???? ???? ???????? ??????????? ?????? ???? ???????? ???? ???????????????????.

????????? ??????? [ ???? ]

??????????????? ????????? ????????? ???????? ???????? ???????????? ??????????????????. ???????, ??????????? ???????????? ?????????????????????. ???????????? ???????? ????????????? ????????? ??????????? ????????????? ?????? ????????? ??????? ?????? ??????????????? ?????? ??????????. ???? ??????? ???????? ??????????????? ?????????? ?????? ???????.

?????????? [ ???? ]

?????????? ????? ????????????????? ???????? ?????? ?? ?????????? ???????????. ??? ??????????????????? ??????????? ?????? ???????? ?????? ?????????. ???????? ????????? ??????? ??????????????? ??? ?????????????????? ?????? ?????????????????? ????????????? ??????????. ????????? ??????????? ??????? ??? ???????????????? ????????????????? ?????? ????????????????? ?????? ?????????????? ??????? ????????????????.

??????????????

??????????? ????? ??????? ??????? ????? ???????? ???? ???? ?????????? ???? ?????? ???????????? ???? ???????????????????? ????????????????? ?????????? ??????? ?????????? ??????????. ???????? ????????? ??????????????? ????????????? ?????????????? ??????? ?????????? ???????????????. ???????????, ??????? ?????? ??? ?????? ????????? ??????????? ?????? ??????? 70-90% ???????? ???????? ??????????? ??? ??????????????? ??? ???????? 1,500 ???? ?????????????????????? ????????????? (????) ????????????? ??????? ???????? 9 ?????????? 5% ?? ?????????????. ????????????? ?????? ????????????????? ???????? ?????????? ????? ????????????????????, ????????????? ???????????? ?????????? ??????????? ????????? ?????????? ????????????? ?????????????????. [67]

???????????

?????? ????????? ?????? ????????? ??????? ????????? ?? ??????? ???? ?????? ???????? ???????? ??????????. ????????????? ?????? (?.??. ???????????? ????????) ????????? ????????? ??????? ????????? ?? ??????? ????????? ???????????????? ??????????????????????????. ??????????????????????? ???????? ???????? ??????????????. ???????? ??????, ????????? ?????? ???????? ??????? ???????????????????? (25-?????????????????????????????) ????????????? ?????????? ??????? ???? ??????????? ?????????? ??????? ???????????? ????????? ?? ???????? ???????????????? ?????? (1,25-????????????????????????????? ?????? ????????? ?????? ??????? ???????? ??????? ???? ???????????? ??????? ?????????????) ????????????????????.

??????? ???? ??????? ???????????????????? ??? ?????????? ????????? ????????? ????????????. ?????? ??????????????? ?????? ????????? ????????????? ????? ????????? ?????????? ????????????????. [68] ??????????? ???????????????? ?????? ???????? ?????????? ????? ???? ???????? ??????????????. ????? ??????? ???????? ?????????????????? ???? ??????????? ??????????. ??????????????? ???????????? ?????????????? ???? ?????? ??????? ?????????????? ???????? ??????? ???????????????. [69]

?????????? [ ???? ]

??????? ??????? ???????? ????????? ????????????? ??????????? ???????????????? ????????????????????. ????????????????? ???????????? ??????????????????? ???? ???????????? ???????????? ??????? ??????? ?????? ?????? ???? ????????? (SERM) ?????????? ????????.

?????? ?????? ???? ???????? ??????? ???????? ??????????????? ???????????? ???????????? ????????? ???????????????. ?????, ???? ?????????, ??????? ?????????????? ???? ???????????????????? ?????? ????????? ??????? ??? ??????????????????????. ????????? ????????????? ???? ???? ????? ????? ???????????? ??????????? ?????? ?????? ???? ???????????????????? ???????? ???????? ??????? ????????????.

??????????? ??????? ????????? ?????????? ?????????????? ??????? ??????????????? ?????????? ??????????????? ???????????????? ?????????. ????? 2008 ????? ??? ??????? ??????????? ?????????? ?????? ????????? ?????????????? ??????? ?????? ?????? ???????? ??????? ?????. [23]

?????? [ ???? ]

??????? ???????????? ???????? ???? ????????????? ??????????????? ????????????? ???????????? ????? ???? ??????? ??????? ??????? ????????? ????????. "?????????????" ???? ???? ???????? ??????? ??????? ????????? ???????????????? ?????? ??????????? ???????? ??????? ????????? ???? ???????????? ??????? ????????? [70] . ???????? ??????????? ??????? ??????????? ???????? ????????? ??????????????? ?????????????????? ???? ????????? ???????????????????? [71] . 1960????? ????????????? ??????????????????? ????????????? ???????????? ??? ????????? ???????????? [72] .

?????????? [ ???? ]

1986 ??? ????? ????? ????????????? ??????? ?????????????. ????????????????? ??????????, ???????? ??????? ?????????? ?????????????????? ??????????????? ??? ??????????? ?? ???????????? . [73] [74]

????? ???????????? ???????? (USA???? ???? ?????????, D.C.,???? ????????? ??????????) ????????????? ??????? ??? ???????? ????????????? ????????, ???????? ????????? ??????????? ??????? ????????????, ??????????????????? ????????????????????? ?????????? ????????? ??????? ??????? ??????????????? ??????????, ???????? ???????, ???? ??????? ??????? ?????????? ??????? ????? ??????????? ????? ???????? ?????? ??????? ??????? ????????? ????????? ??????????????. http://www.nof.org

??????? ????????????? ???????? (IOF) (????????????????? ???? ???????? ????????? ????????????): ?????????? ????????? ???????, ???????? ??????? ????????? ??????????, ???????????, ??????? ?????????? ?????????? ??????????? ??????? ??????? ?????????? ???????? ?????????????? ??????? ??????????? ????????? ????? ?????????. http://www.iofbonehealth.org

?????????? ????????? ??????? (USA, ??????????, IL?? ????????? ????????????) ?????? ??? ????????? ??????? ?????????? ??????? ????????? ???????????. ??? ?? ?????????? ????????????? ?????????, ???????? ??????? ???????? ??????????? ????????. http://www.ors.org

?????? ????? [ ???? ]

??????????? [ ???? ]

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