T\u1eeb l\u00e2u nay, b\u1ed5 sung vitamin D v\u00e0 calci \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o r\u1ed9ng r\u00e3i cho ng\u01b0\u1eddi cao tu\u1ed5i \u0111\u1ec3 ph\u00f2ng ng\u1eeba lo\u00e3ng x\u01b0\u01a1ng. Tuy nhi\u00ean, nh\u1eefng nghi\u00ean c\u1ee9u m\u1edbi c\u00f4ng b\u1ed1 trong n\u0103m 2018 \u0111\u01b0\u1ee3c t\u1ea1p ch\u00ed NEJM danh ti\u1ebfng \u0111\u0103ng t\u1ea3i ch\u01b0a t\u00ecm th\u1ea5y l\u1ee3i \u00edch r\u00f5 r\u00e0ng c\u1ee7a vi\u1ec7c b\u1ed5 sung vitamin D n\u00e0y.<\/p>\n
M\u1ed9t th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng ng\u1eabu nhi\u00ean, m\u1ed9t ph\u00e2n t\u00edch g\u1ed9p v\u00e0 m\u1ed9t h\u01b0\u1edbng d\u1eabn \u0111i\u1ec1u tr\u1ecb m\u1edbi \u0111\u01b0\u1ee3c c\u00f4ng b\u1ed1 trong n\u0103m 208 \u0111\u00e3 c\u00f9ng \u0111\u1ed3ng thu\u1eadn khuy\u1ebfn c\u00e1o v\u1ec1 vi\u1ec7c s\u1eed d\u1ee5ng vitamin D trong ph\u00f2ng ng\u1eeba c\u00e1c r\u1ed1i lo\u1ea1n v\u1ec1 x\u01b0\u01a1ng kh\u1edbp v\u00e0 c\u00e1c r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng c\u01a1 th\u1ec3 kh\u00e1c. Nh\u1eefng nghi\u00ean c\u1ee9u n\u00e0y \u0111\u00e3 \u0111\u01b0\u1ee3c t\u1ea1p ch\u00ed NEJM uy t\u00edn \u0111\u0103ng t\u1ea3i.<\/p>\n
Th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng VITAL (th\u1eed nghi\u1ec7m v\u1ec1 vitamin D v\u00e0 Omega 3) \u0111\u00e3 \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n tr\u00ean 26000 ng\u01b0\u1eddi trung ni\u00ean v\u00e0 ng\u01b0\u1eddi cao tu\u1ed5i kh\u00f4ng c\u00f3 ti\u1ec1n s\u1eed m\u1eafc b\u1ec7nh tim m\u1ea1ch (CV), ung th\u01b0 hay c\u00e1c r\u1ed1i lo\u1ea1n nghi\u00eam tr\u1ecdng kh\u00e1c. C\u00e1c \u0111\u1ed1i t\u01b0\u1ee3ng tham gia \u0111\u01b0\u1ee3c l\u1ef1a ch\u1ecdn ng\u1eabu nhi\u00ean \u0111\u1ec3 s\u1eed d\u1ee5ng vitamin D3 (li\u1ec1u 2000 IU\/ng\u00e0y) ho\u1eb7c gi\u1ea3 d\u01b0\u1ee3c. K\u1ebft qu\u1ea3 cho th\u1ea5y, n\u1ed3ng \u0111\u1ed3 trung b\u00ecnh c\u1ee7a 25-hydroxyvitamin D trong huy\u1ebft thanh ch\u1ec9 t\u0103ng \u1edf nh\u00f3m s\u1eed d\u1ee5ng vitamin D3. Trong su\u1ed1t th\u1eddi gian theo d\u00f5i (trung b\u00ecnh 5 n\u0103m), nh\u1eefng bi\u1ebfn c\u1ed1 tim m\u1ea1ch nghi\u00eam tr\u1ecdng v\u00e0 t\u00ecnh tr\u1ea1ng ung th\u01b0 kh\u00f4ng x\u00e2m l\u1ea5n x\u1ea3y ra \u1edf c\u1ea3 2 nh\u00f3m v\u1edbi t\u1ec9 l\u1ec7 ngang nhau. (NEJM JW Gen Med ng\u00e0y 15\/12\/2018 v\u00e0 N Engl J Med ng\u00e0y 10\/10\/2018; [e-pub]).<\/p>\n
M\u1ed9t ph\u00e2n t\u00edch g\u1ed9p tr\u00ean 33 th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng ng\u1eabu nhi\u00ean v\u1ec1 t\u00e1c d\u1ee5ng c\u1ee7a vi\u1ec7c b\u1ed5 sung calci v\u00e0 vitamin D \u0111\u1ed1i v\u1edbi t\u1ef7 l\u1ec7 g\u00e3y x\u01b0\u01a1ng \u1edf nh\u1eefng ng\u01b0\u1eddi l\u1edbn tu\u1ed5i (\u2265 50 tu\u1ed5i). K\u1ebft qu\u1ea3 cho th\u1ea5y vi\u1ec7c b\u1ed5 sung calcium v\u00e0 vitamin D kh\u00f4ng l\u00e0m gi\u1ea3m t\u1ec9 l\u1ec7 g\u00e3y x\u01b0\u01a1ng h\u00f4ng, x\u01b0\u01a1ng c\u1ed9t s\u1ed1ng hay b\u1ea5t k\u00ec v\u1ecb tr\u00ed n\u00e0o kh\u00e1c. K\u1ebft qu\u1ea3 tr\u00ean v\u1eabn \u0111\u01b0\u1ee3c l\u1eb7p l\u1ea1i \u1edf nh\u00f3m c\u00e1c \u0111\u1ed1i t\u01b0\u1ee3ng nghi\u00ean c\u1ee9u c\u00f3 n\u1ed3ng \u0111\u1ed9 25-hydroxyvitamin D th\u1ea5p h\u01a1n 20 ng\/mL ho\u1eb7c \u0111\u00e3 t\u1eebng b\u1ecb g\u00e3y x\u01b0\u01a1ng (NEJM JW Gen Med Feb 15 and JAMA 2017 Dec 26; 318:2466).<\/p>\n
Tr\u01b0\u1edbc c\u00e1c k\u1ebft qu\u1ea3 thu \u0111\u01b0\u1ee3c, C\u01a1 quan Y t\u1ebf d\u1ef1 ph\u00f2ng Hoa K\u00ec (USPSTF) \u0111\u00e3 c\u1eadp nh\u1eadt c\u00e1c h\u01b0\u1edbng d\u1eabn tr\u01b0\u1edbc \u0111\u00e2y v\u1ec1 vi\u1ec7c b\u1ed5 sung vitamin D. C\u00e1c c\u01a1 quan ch\u1ee9c n\u0103ng \u0111\u00e3 c\u00f3 \u0111\u1ee7 b\u1eb1ng ch\u1ee9ng cho th\u1ea5y b\u1ed5 sung vitamin D kh\u00f4ng ng\u0103n ng\u1eeba \u0111\u01b0\u1ee3c nguy c\u01a1 g\u00e3y x\u01b0\u01a1ng \u1edf c\u1ea3 \u0111\u00e0n \u00f4ng v\u00e0 ph\u1ee5 n\u1eef ti\u1ec1n m\u00e3n kinh v\u00e0 kh\u00f4ng khuy\u1ebfn c\u00e1o s\u1eed d\u1ee5ng vitamin D cho m\u1ee5c \u0111\u00edch n\u00e0y. Ph\u1ee5 n\u1eef sau th\u1eddi k\u00ec m\u00e3n kinh kh\u00f4ng n\u00ean b\u1ed5 sung vitamin D li\u1ec1u th\u1ea5p, v\u00e0 c\u0169ng ch\u01b0a c\u00f3 \u0111\u1ee7 b\u1eb1ng ch\u1ee9ng cho vi\u1ec7c b\u1ed5 sung vitamin D li\u1ec1u cao c\u00f3 ng\u0103n ng\u1eeba \u0111\u01b0\u1ee3c g\u00e3y x\u01b0\u01a1ng hay kh\u00f4ng. USPSTF nh\u1ea5n m\u1ea1nh khuy\u1ebfn c\u00e1o tr\u00ean ch\u1ec9 \u00e1p d\u1ee5ng cho ng\u01b0\u1eddi cao tu\u1ed5i ch\u01b0a c\u00f3 ti\u1ec1n s\u1eed b\u1ecb lo\u00e3ng x\u01b0\u01a1ng ho\u1eb7c thi\u1ebfu h\u1ee5t vitamin D.<\/p>\n
Nghi\u00ean c\u1ee9u VITAL c\u00f9ng nhi\u1ec1u nghi\u00ean c\u1ee9u v\u1ec1 m\u1ed1i quan h\u1ec7 vitamin D li\u1ec1u th\u1ea5p v\u00e0 c\u00e1c t\u00ecnh tr\u1ea1ng b\u1ec7nh l\u00fd kh\u00e1c ch\u01b0a t\u00ecm th\u1ea5y l\u1ee3i \u00edch c\u1ee7a vi\u1ec7c b\u1ed5 sung vitamin D. Tuy nhi\u00ean, USPSTF nh\u1eadn \u0111\u1ecbnh tr\u01b0\u1edbc th\u1ef1c t\u1ebf s\u1ef1 khuy\u1ebfn c\u00e1o s\u1eed d\u1ee5ng vitamin D r\u1ed9ng r\u00e3i c\u1ee7a c\u00e1c b\u00e1c s\u0129 c\u00f9ng v\u1edbi s\u1ef1 s\u1eb5n c\u00f3 c\u1ee7a c\u00e1c ch\u1ebf ph\u1ea9m vitamin D kh\u00f4ng c\u1ea7n k\u00ea \u0111\u01a1n tr\u00ean th\u1ecb tr\u01b0\u1eddng th\u00ec t\u1ec9 l\u1ec7 s\u1eed d\u1ee5ng vitamin D s\u1ebd kh\u00f3 c\u00f3 th\u1ec3 suy gi\u1ea3m.<\/p>\n
Ngu\u1ed3n: \u1ea4n b\u1ea3n NEJM Journal Watch (General Meidicne) Year in Review 2018, Editor Allan S. Brett, MD<\/p>\n