{"id":5479,"date":"2019-03-26T00:57:42","date_gmt":"2019-03-25T17:57:42","guid":{"rendered":"https:\/\/www.vnras.com\/drug\/?p=5479"},"modified":"2019-03-26T00:57:42","modified_gmt":"2019-03-25T17:57:42","slug":"jama-lien-quan-giua-luong-cholesterol-trong-che-do-an-va-luong-trung-tieu-thu-voi-bien-co-tim-mach-va-tu-vong","status":"publish","type":"post","link":"https:\/\/vnras.com\/drug\/jama-lien-quan-giua-luong-cholesterol-trong-che-do-an-va-luong-trung-tieu-thu-voi-bien-co-tim-mach-va-tu-vong\/","title":{"rendered":"[JAMA] Li\u00ean quan gi\u1eefa l\u01b0\u1ee3ng cholesterol trong ch\u1ebf \u0111\u1ed9 \u0103n v\u00e0 l\u01b0\u1ee3ng tr\u1ee9ng ti\u00eau th\u1ee5 v\u1edbi bi\u1ebfn c\u1ed1 tim m\u1ea1ch v\u00e0 t\u1eed vong"},"content":{"rendered":"<p><strong>Cholesterol<\/strong> l\u00e0 th\u00e0nh ph\u1ea7n dinh d\u01b0\u1ee1ng th\u01b0\u1eddng g\u1eb7p trong ch\u1ebf \u0111\u1ed9 \u0103n c\u1ee7a ng\u01b0\u1eddi, m\u00e0 tr\u1ee9ng l\u1ea1i l\u00e0 m\u1ed9t ngu\u1ed3n cholesterol ch\u00ednh trong ch\u1ebf \u0111\u1ed9 \u0103n. V\u1eabn c\u00f2n nhi\u1ec1u tranh c\u00e3i v\u1ec1 vi\u1ec7c l\u01b0\u1ee3ng cholesterol trong ch\u1ebf \u0111\u1ed9 \u0103n v\u00e0 l\u01b0\u1ee3ng tr\u1ee9ng \u0103n v\u00e0o c\u00f3 li\u00ean quan \u0111\u1ebfn b\u1ec7nh tim m\u1ea1ch (CVD) v\u00e0 t\u1eed vong hay kh\u00f4ng.<\/p>\n<p>Ch\u00ednh v\u00ec v\u1eady, c\u00e1c t\u00e1c gi\u1ea3 \u0111\u00e3 ti\u1ebfn h\u00e0nh ph\u00e2n t\u00edch x\u00e1c \u0111\u1ecbnh m\u1ed1i li\u00ean h\u1ec7 n\u00f3i tr\u00ean b\u1eb1ng d\u1eef li\u1ec7u g\u1ed9p t\u1eeb 6 nghi\u00ean c\u1ee9u thu\u1ea7n t\u1eadp ti\u1ebfn c\u1ee9u thu th\u1eadp t\u1eeb 25\/03\/1985 \u0111\u1ebfn 31\/08\/2016. C\u00e1c d\u1eef li\u1ec7u v\u1ec1 ch\u1ebf \u0111\u1ed9 \u0103n do \u0111\u1ed1i t\u01b0\u1ee3ng t\u1ef1 khai b\u00e1o \u0111\u01b0\u1ee3c th\u1ed1ng nh\u1ea5t theo qui tr\u00ecnh nghi\u00ean c\u1ee9u chu\u1ea9n ho\u00e1. Ph\u01a1i nhi\u1ec5m nghi\u00ean c\u1ee9u l\u00e0 l\u01b0\u1ee3ng cholesterol trong ch\u1ebf \u0111\u1ed9 \u0103n (mg\/ ng\u00e0y) v\u00e0 l\u01b0\u1ee3ng tr\u1ee9ng \u0103n v\u00e0o (s\u1ed1 qu\u1ea3\/ng\u00e0y). Ch\u1ec9 s\u1ed1 \u0111\u1ea7u ra v\u00e0 bi\u1ebfn \u0111o l\u01b0\u1eddng ch\u00ednh bao g\u1ed3m t\u1ec9 s\u1ed1 nguy c\u01a1 (hazard ratio &#8211; HR) v\u00e0 ch\u00eanh l\u1ec7ch nguy c\u01a1 tuy\u1ec7t \u0111\u1ed1i (absolute risk difference &#8211; ARD) trong to\u00e0n b\u1ed9 qu\u00e1 tr\u00ecnh theo d\u00f5i v\u1ec1 bi\u1ebfn c\u1ed1 tim m\u1ea1ch (bi\u1ebfn ph\u1ee9c h\u1ee3p b\u1ec7nh m\u1ea1ch v\u00e0nh g\u00e2y t\u1eed vong v\u00e0 kh\u00f4ng t\u1eed vong, \u0111\u1ed9t qu\u1ecb, suy tim v\u00e0 c\u00e1c t\u1eed vong do b\u1ec7nh tim m\u1ea1ch kh\u00e1c) v\u00e0 t\u1eed vong do m\u1ecdi nguy\u00ean nh\u00e2n, hi\u1ec7u ch\u1ec9nh theo nh\u00e2n kh\u1ea9u h\u1ecdc, kinh t\u1ebf x\u00e3 h\u1ed9i h\u1ecdc v\u00e0 c\u00e1c y\u1ebfu t\u1ed1 h\u00e0nh vi.<\/p>\n<p>Nghi\u00ean c\u1ee9u \u0111\u01b0\u1ee3c ti\u1ebfn h\u00e0nh tr\u00ean 29.615 \u0111\u1ed1i t\u01b0\u1ee3ng (tu\u1ed5i trung b\u00ecnh t\u1ea1i th\u1eddi \u0111i\u1ec3m ban \u0111\u1ea7u [\u0111\u1ed9 l\u1ec7ch chu\u1ea9n] l\u00e0 51.6 [13.5]), trong \u0111\u00f3 c\u00f3 13.299 (44,9%) nam gi\u1edbi v\u00e0 9.204 (31,1%) ng\u01b0\u1eddi da \u0111en. Trong qu\u00e1 tr\u00ecnh theo d\u00f5i trung v\u1ecb l\u00e0 17,5 n\u0103m (kho\u1ea3ng li\u00ean t\u1ee9 ph\u00e2n v\u1ecb l\u00e0 13,0-21,7; t\u1ed1i \u0111a l\u00e0 31,3 n\u0103m), c\u00f3 5.400 bi\u1ebfn c\u1ed1 tim m\u1ea1ch v\u00e0 6.132 tr\u01b0\u1eddng h\u1ee3p t\u1eed vong do m\u1ecdi nguy\u00ean nh\u00e2n. M\u1ed1i li\u00ean quan gi\u1eefa l\u01b0\u1ee3ng cholesterol trong ch\u1ebf \u0111\u1ed9 \u0103n hay l\u01b0\u1ee3ng tr\u1ee9ng \u0103n v\u00e0o v\u1edbi nguy c\u01a1 bi\u1ebfn c\u1ed1 tim m\u1ea1ch v\u00e0 t\u1eed vong do m\u1ecdi nguy\u00ean nh\u00e2n l\u00e0 \u0111\u01a1n \u0111i\u1ec7u (t\u1ea5t c\u1ea3 c\u00e1c gi\u00e1 tr\u1ecb P \u0111\u1ed1i v\u1edbi h\u1ea1ng t\u1eed kh\u00f4ng tuy\u1ebfn t\u00ednh l\u00e0 t\u1eeb 0,19-0,83). C\u1ee9 th\u00eam v\u00e0o ch\u1ebf \u0111\u1ed9 \u0103n h\u00e0ng ng\u00e0y kho\u1ea3ng 300 mg cholesterol th\u00ec t\u0103ng c\u00f3 \u00fd ngh\u0129a th\u1ed1ng k\u00ea nguy c\u01a1 bi\u1ebfn c\u1ed1 tim m\u1ea1ch (HR hi\u1ec7u ch\u1ec9nh l\u00e0 1,17 [kho\u1ea3ng tin c\u1eady 95% l\u00e0 1,09-1,26]; ARD hi\u1ec7u ch\u1ec9nh l\u00e0 3,24% [kho\u1ea3ng tin c\u1eady 95% l\u00e0 1,39%-5,08%]) v\u00e0 nguy c\u01a1 t\u1eed vong do m\u1ecdi nguy\u00ean nh\u00e2n (HR hi\u1ec7u ch\u1ec9nh l\u00e0 1,18 [kho\u1ea3ng tin c\u1eady 95% l\u00e0 1,10-1,26]; ARD hi\u1ec7u ch\u1ec9nh l\u00e0 4,43% [kho\u1ea3ng tin c\u1eady 95% l\u00e0 2,51%-6,36%]). M\u1ed7i ng\u00e0y \u0103n th\u00eam m\u1ed9t qu\u1ea3 tr\u1ee9ng th\u00ec t\u0103ng c\u00f3 \u00fd ngh\u0129a th\u1ed1ng k\u00ea nguy c\u01a1 bi\u1ebfn c\u1ed1 tim m\u1ea1ch (HR hi\u1ec7u ch\u1ec9nh l\u00e0 1,06 [kho\u1ea3ng tin c\u1eady 95% l\u00e0 1,03-1,10]; ARD hi\u1ec7u ch\u1ec9nh l\u00e0 1,11% [kho\u1ea3ng tin c\u1eady 95% l\u00e0 0,32%-1,89%]) v\u00e0 nguy c\u01a1 t\u1eed vong do m\u1ecdi nguy\u00ean nh\u00e2n (HR hi\u1ec7u ch\u1ec9nh l\u00e0 1,08 [kho\u1ea3ng tin c\u1eady 95% l\u00e0 1,04-1,11]; ARD hi\u1ec7u ch\u1ec9nh l\u00e0 1,93% [kho\u1ea3ng tin c\u1eady 95% l\u00e0 1,10%-2,76%]). M\u1ed1i li\u00ean h\u1ec7 gi\u1eefa l\u01b0\u1ee3ng tr\u1ee9ng \u0103n v\u00e0o v\u00e0 nguy c\u01a1 bi\u1ebfn c\u1ed1 tim m\u1ea1ch (HR hi\u1ec7u ch\u1ec9nh l\u00e0 0,99 [kho\u1ea3ng tin c\u1eady 95% l\u00e0 0,93-1,05]; ARD hi\u1ec7u ch\u1ec9nh l\u00e0 -0,47% [kho\u1ea3ng tin c\u1eady 95% l\u00e0 -1,83% \u0111\u1ebfn 0,88%]) v\u00e0 nguy c\u01a1 t\u1eed vong do m\u1ecdi nguy\u00ean nh\u00e2n (HR hi\u1ec7u ch\u1ec9nh l\u00e0 1,03 [kho\u1ea3ng tin c\u1eady 95% l\u00e0 0,97-1,09]; ARD hi\u1ec7u ch\u1ec9nh l\u00e0 0,71% [kho\u1ea3ng tin c\u1eady 95% l\u00e0 \u22120,85% \u0111\u1ebfn 2,28%]) kh\u00f4ng c\u00f2n c\u00f3 \u00fd ngh\u0129a th\u1ed1ng k\u00ea khi hi\u1ec7u ch\u1ec9nh theo l\u01b0\u1ee3ng cholesterol trong ch\u1ebf \u0111\u1ed9 \u0103n.<\/p>\n<p>T\u1eeb nghi\u00ean c\u1ee9u n\u00e0y c\u00e1c t\u00e1c gi\u1ea3 r\u00fat ra k\u1ebft lu\u1eadn: \u1edf ng\u01b0\u1eddi Hoa K\u00ec tr\u01b0\u1edfng th\u00e0nh, l\u01b0\u1ee3ng cholesterol trong ch\u1ebf \u0111\u1ed9 \u0103n ho\u1eb7c l\u01b0\u1ee3ng tr\u1ee9ng \u0103n v\u00e0o c\u00e0ng cao c\u00f3 th\u1ec3 d\u1eabn t\u1edbi nguy c\u01a1 c\u00e0ng cao xu\u1ea5t hi\u1ec7n bi\u1ebfn c\u1ed1 tim m\u1ea1ch v\u00e0 t\u1eed vong do m\u1ecdi nguy\u00ean nh\u00e2n theo ki\u1ec3u ph\u1ee5 thu\u1ed9c li\u1ec1u. C\u1ea7n xem x\u00e9t c\u00e1c k\u1ebft qu\u1ea3 n\u00e0y khi \u0111\u01b0a ra c\u00e1c h\u01b0\u1edbng d\u1eabn v\u00e0 c\u1eadp nh\u1eadt v\u1ec1 ch\u1ebf \u0111\u1ed9 \u0103n.<\/p>\n<p>Ngu\u1ed3n: JAMA.\u00a0<a href=\"https:\/\/jamanetwork.com\/journals\/jama\/fullarticle\/2728487\" rel=\"noopener\">https:\/\/jamanetwork.com\/journals\/jama\/fullarticle\/2728487<\/a><\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Cholesterol l\u00e0 th\u00e0nh ph\u1ea7n dinh d\u01b0\u1ee1ng th\u01b0\u1eddng g\u1eb7p trong ch\u1ebf \u0111\u1ed9 \u0103n c\u1ee7a ng\u01b0\u1eddi, m\u00e0 tr\u1ee9ng l\u1ea1i l\u00e0 m\u1ed9t ngu\u1ed3n cholesterol ch\u00ednh trong ch\u1ebf \u0111\u1ed9 \u0103n. V\u1eabn c\u00f2n nhi\u1ec1u tranh c\u00e3i v\u1ec1 vi\u1ec7c l\u01b0\u1ee3ng cholesterol trong ch\u1ebf \u0111\u1ed9 \u0103n v\u00e0 l\u01b0\u1ee3ng tr\u1ee9ng \u0103n v\u00e0o c\u00f3 li\u00ean quan \u0111\u1ebfn b\u1ec7nh tim m\u1ea1ch (CVD) v\u00e0 t\u1eed vong [&#8230;]\n","protected":false},"author":1,"featured_media":5480,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[1],"tags":[],"class_list":["post-5479","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-y-te-suc-khoe"],"acf":[],"_links":{"self":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/posts\/5479","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/comments?post=5479"}],"version-history":[{"count":0,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/posts\/5479\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/media\/5480"}],"wp:attachment":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/media?parent=5479"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/categories?post=5479"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/tags?post=5479"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}