{"id":33277,"date":"2024-03-13T02:33:13","date_gmt":"2024-03-12T18:33:13","guid":{"rendered":"https:\/\/docquity.com\/?post_type=articles&p=33277"},"modified":"2025-02-11T13:39:42","modified_gmt":"2025-02-11T05:39:42","slug":"luong-muoi-tieu-thu-va-nguy-co-cua-benh-than-man","status":"publish","type":"articles","link":"https:\/\/docquity.com\/vi\/articles\/luong-muoi-tieu-thu-va-nguy-co-cua-benh-than-man\/","title":{"rendered":"L\u01b0\u1ee3ng mu\u1ed1i ti\u00eau th\u1ee5 v\u00e0 nguy c\u01a1 c\u1ee7a b\u1ec7nh th\u1eadn m\u1ea1n"},"content":{"rendered":"\n

Mu\u1ed1i c\u00f3 vai tr\u00f2 quan tr\u1ecdng \u0111\u1ed1i v\u1edbi c\u01a1 th\u1ec3 con ng\u01b0\u1eddi, mu\u1ed1i g\u00f3p m\u1eb7t trong nhi\u1ec1u ch\u1ee9c n\u0103ng sinh l\u00fd, bao g\u1ed3m duy tr\u00ec c\u00e2n b\u1eb1ng d\u1ecbch v\u00e0 h\u1ea5p thu ch\u1ea5t dinh d\u01b0\u1ee1ng1<\/sup>. M\u1ed1i li\u00ean h\u1ec7 gi\u1eefa vi\u1ec7c ti\u00eau th\u1ee5 nhi\u1ec1u natri v\u00e0 t\u0103ng huy\u1ebft \u00e1p \u0111\u00e3 \u0111\u01b0\u1ee3c l\u00e0m r\u00f5 qua nhi\u1ec1u nghi\u00ean c\u1ee9u2<\/sup>. Nh\u01b0ng m\u1eb7t kh\u00e1c, t\u0103ng huy\u1ebft \u00e1p l\u1ea1i c\u00f3 li\u00ean quan \u0111\u1ebfn vi\u1ec7c l\u00e0m gia t\u0103ng nguy c\u01a1 c\u1ee7a b\u1ec7nh th\u1eadn m\u1ea1n 3, 4<\/sup>. T\u0103ng huy\u1ebft \u00e1p v\u00e0 b\u1ec7nh th\u1eadn m\u1ea1n c\u0169ng c\u00f3 nhi\u1ec1u y\u1ebfu t\u1ed1 nguy c\u01a1 chung, \u0111\u1eb7c bi\u1ec7t l\u00e0 l\u01b0\u1ee3ng mu\u1ed1i ti\u00eau th\u1ee55, 6<\/sup>.<\/p>\n\n\n\n

M\u1eb7c d\u00f9 nhi\u1ec1u nghi\u00ean c\u1ee9u \u0111\u00e3 cho th\u1ea5y m\u1ed1i li\u00ean h\u1ec7 gi\u1eefa l\u01b0\u1ee3ng mu\u1ed1i ti\u00eau th\u1ee5 v\u00e0 nguy c\u01a1 c\u1ee7a b\u1ec7nh th\u1eadn m\u1ea1n, \u0111a s\u1ed1 nghi\u00ean c\u1ee9u n\u00e0y ch\u1ec9 bao g\u1ed3m c\u00e1c b\u1ec7nh nh\u00e2n v\u1ed1n d\u0129 \u0111\u00e3 \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n m\u1eafc t\u0103ng huy\u1ebft \u00e1p, \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng ho\u1eb7c c\u00e1c b\u1ec7nh m\u1ea1n t\u00ednh kh\u00e1c7, 8<\/sup>. Ch\u1ec9 c\u00f3 m\u1ed9t s\u1ed1 \u00edt nghi\u00ean c\u1ee9u cho th\u1ea5y m\u1ed1i li\u00ean h\u1ec7 gi\u1eefa l\u01b0\u1ee3ng mu\u1ed1i ti\u00eau th\u1ee5 v\u00e0 nguy c\u01a1 c\u1ee7a b\u1ec7nh th\u1eadn m\u1ea1n \u1edf nh\u00f3m d\u00e2n s\u1ed1 chung9<\/sup>.<\/p>\n\n\n\n

M\u1ed9t nh\u00f3m nghi\u00ean c\u1ee9u cho r\u1eb1ng vi\u1ec7c th\u01b0\u1eddng xuy\u00ean b\u1ed5 sung mu\u1ed1i v\u00e0o th\u1ee9c \u0103n c\u00f3 li\u00ean quan \u0111\u1ebfn vi\u1ec7c l\u00e0m t\u0103ng nguy c\u01a1 m\u1eafc b\u1ec7nh tim m\u1ea1ch, t\u1eed vong s\u1edbm v\u00e0 \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng type 2. H\u01a1n n\u1eefa, nghi\u00ean c\u1ee9u n\u00e0y c\u0169ng cho th\u1ea5y vi\u1ec7c b\u1ed5 sung mu\u1ed1i th\u01b0\u1eddng xuy\u00ean v\u00e0o th\u1ee9c \u0103n c\u0169ng c\u00f3 li\u00ean quan \u0111\u1ebfn n\u1ed3ng \u0111\u1ed9 thanh th\u1ea3i natri trong n\u01b0\u1edbc ti\u1ec3u 24 gi\u1edd 10 \u2013 12<\/sup>.<\/p>\n\n\n\n

M\u1ed9t nghi\u00ean c\u1ee9u m\u1edbi v\u1eeba \u0111\u01b0\u1ee3c \u0111\u0103ng tr\u00ean t\u1ea1p ch\u00ed JAMA Network<\/em> Open th\u00e1ng 1 v\u1eeba qua \u0111\u00e3 \u0111\u01b0a ra c\u00e2u tr\u1ea3 l\u1eddi r\u00f5 r\u00e0ng v\u1ec1 t\u1ea7n su\u1ea5t b\u1ed5 sung mu\u1ed1i v\u00e0o b\u1eefa \u0103n v\u1edbi nguy c\u01a1 c\u1ee7a b\u1ec7nh th\u1eadn m\u1ea1n \u1edf ng\u01b0\u1eddi tr\u01b0\u1edfng th\u00e0nh n\u00f3i chung [9]. B\u00e0i vi\u1ebft nh\u1eb1m m\u1ee5c \u0111\u00edch t\u00f3m t\u1eaft nghi\u00ean c\u1ee9u n\u00e0y.<\/p>\n\n\n\n

Mu\u1ed1i \u0103n v\u00e0 mu\u1ed1i bi\u1ec3n<\/strong><\/p>\n\n\n\n

S\u1ef1 kh\u00e1c bi\u1ec7t ch\u00ednh gi\u1eefa mu\u1ed1i bi\u1ec3n v\u00e0 mu\u1ed1i \u0103n n\u1eb1m \u1edf v\u1ecb, c\u1ea5u tr\u00fac v\u00e0 quy tr\u00ecnh ch\u1ebf bi\u1ebfn. Mu\u1ed1i \u0103n th\u01b0\u1eddng \u0111\u01b0\u1ee3c k\u1ebft h\u1ea1t m\u00e0u tr\u1eafng. Mu\u1ed1i \u0103n \u0111\u01b0\u1ee3c ch\u1ebf bi\u1ebfn v\u1edbi quy tr\u00ecnh ph\u00e2n t\u00e1ch c\u00e1c lo\u1ea1i kho\u00e1ng kh\u00e1c v\u00e0 \u0111\u01b0\u1ee3c b\u1ed5 sung iod \u2013 m\u1ed9t th\u00e0nh ph\u1ea7n quan tr\u1ecdng cho s\u1ee9c kh\u1ecfe tuy\u1ebfn gi\u00e1p9<\/sup>.<\/p>\n\n\n\n

Mu\u1ed1i bi\u1ec3n l\u00e0 thu\u1eadt ng\u1eef \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111\u1ec1 c\u1eadp \u0111\u1ebfn lo\u1ea1i mu\u1ed1i \u0111\u01b0\u1ee3c s\u1ea3n xu\u1ea5t qua qu\u00e1 tr\u00ecnh l\u00e0m b\u1ed1c h\u01a1i n\u01b0\u1edbc bi\u1ec3n ho\u1eb7c b\u1ed1c h\u01a1i n\u01b0\u1edbc c\u1ee7a h\u1ed3 n\u01b0\u1edbc m\u1eb7n. Quy tr\u00ecnh s\u1ea3n xu\u1ea5t mu\u1ed1i bi\u1ec3n th\u01b0\u1eddng \u00edt ph\u1ee9c t\u1ea1p h\u01a1n quy tr\u00ecnh s\u1ea3n xu\u1ea5t mu\u1ed1i \u0103n, mu\u1ed1i bi\u1ec3n th\u00e0nh ph\u1ea9m th\u01b0\u1eddng v\u1eabn c\u00f3 m\u1ed9t l\u01b0\u1ee3ng nh\u1ecf kho\u00e1ng trong th\u00e0nh ph\u1ea7n.<\/p>\n\n\n\n

Mu\u1ed1i bi\u1ec3n th\u01b0\u1eddng \u0111\u01b0\u1ee3c bi\u1ebft \u0111\u1ebfn r\u1ed9ng r\u00e3i l\u00e0 t\u1ed1t cho s\u1ee9c kh\u1ecfe h\u01a1n mu\u1ed1i \u0103n. Nh\u01b0ng mu\u1ed1i bi\u1ec3n v\u00e0 mu\u1ed1i \u0103n l\u1ea1i c\u00f3 gi\u00e1 tr\u1ecb dinh d\u01b0\u1ee1ng c\u01a1 b\u1ea3n t\u01b0\u01a1ng t\u1ef1. Kh\u1ed1i l\u01b0\u1ee3ng natri trong mu\u1ed1i bi\u1ec3n v\u00e0 mu\u1ed1i \u0103n th\u01b0\u1eddng t\u01b0\u01a1ng t\u1ef1 nhau. H\u01b0\u1edbng d\u1eabn Ch\u1ebf \u0111\u1ed9 \u0103n c\u1ee7a Hoa K\u1ef3 khuy\u1ebfn c\u00e1o ti\u00eau th\u1ee5 l\u01b0\u1ee3ng mu\u1ed1i < 2.300 mg\/ng\u00e0y9<\/sup>.<\/p>\n\n\n\n

Thi\u1ebft k\u1ebf nghi\u00ean c\u1ee9u<\/strong><\/p>\n\n\n\n

Nghi\u00ean c\u1ee9u s\u1eed d\u1ee5ng d\u1eef li\u1ec7u UKB, m\u1ed9t c\u01a1 s\u1edf d\u1eef li\u1ec7u qu\u1ed1c gia \u0111\u01b0\u1ee3c x\u00e2y d\u1ef1ng \u0111\u1ec3 c\u1ea3i thi\u1ec7n ph\u00f2ng ng\u1eeba, ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb c\u00e1c b\u1ec7nh l\u00fd. C\u01a1 s\u1edf d\u1eef li\u1ec7u ch\u1ee9a d\u1eef li\u1ec7u c\u1ee7a h\u01a1n 500,000 ng\u01b0\u1eddi tham gia trong \u0111\u1ed9 tu\u1ed5i 37 \u2013 73 trong kho\u1ea3ng th\u1eddi gian 2006 \u2013 2010.<\/p>\n\n\n\n

Th\u00f4ng tin v\u1ec1 l\u01b0\u1ee3ng mu\u1ed1i ti\u00eau th\u1ee5 v\u00e0 ch\u1ebf \u0111\u1ed9 \u0103n \u0111\u01b0\u1ee3c thu th\u1eadp qua b\u1ea3ng c\u00e2u h\u1ecfi tr\u00ean m\u00e0n h\u00ecnh \u0111i\u1ec7n t\u1eed. \u0110\u00e1nh gi\u00e1 t\u1ea7n su\u1ea5t b\u1ed5 sung mu\u1ed1i v\u00e0o b\u1eefa \u0103n c\u1ee7a ng\u01b0\u1eddi tham gia nghi\u00ean c\u1ee9u d\u1ef1a tr\u00ean c\u00e2u tr\u1ea3 l\u1eddi c\u00e2u h\u1ecfi \u201cB\u1ea1n c\u00f3 b\u1ed5 sung mu\u1ed1i v\u00e0o th\u1ee9c \u0103n kh\u00f4ng (kh\u00f4ng bao g\u1ed3m mu\u1ed1i n\u00eam m\u00f3n \u0103n khi n\u1ea5u)?\u201d. \u0110\u00e1p \u00e1n \u0111\u01b0\u1ee3c chia th\u00e0nh 5 m\u1ee9c \u0111\u1ed9: (i) kh\u00f4ng bao gi\u1edd\/hi\u1ebfm khi; (ii) thi tho\u1ea3ng; (iii) th\u01b0\u1eddng xuy\u00ean; (iv) lu\u00f4n lu\u00f4n v\u00e0 (vi) kh\u00f4ng mu\u1ed1n tr\u1ea3 l\u1eddi. Nh\u1eefng ng\u01b0\u1eddi tham gia l\u1ef1a ch\u1ecdn \u0111\u00e1p \u00e1n (vi) kh\u00f4ng mu\u1ed1n tr\u1ea3 l\u1eddi \u0111\u01b0\u1ee3c xem l\u00e0 d\u1eef li\u1ec7u b\u1ecb thi\u1ebfu v\u00e0 ng\u01b0\u1eddi tham gia \u0111\u00f3 b\u1ecb lo\u1ea1i tr\u1eeb kh\u1ecfi nghi\u00ean c\u1ee9u. \u0110\u1ec3 \u0111\u00e1nh gi\u00e1 ch\u1ebf \u0111\u1ed9 \u0103n, ng\u01b0\u1eddi tham gia nghi\u00ean c\u1ee9u tr\u1ea3 l\u1eddi c\u00e2u h\u1ecfi \u201cB\u1ea1n c\u00f3 thay \u0111\u1ed5i g\u00ec v\u1ec1 ch\u1ebf \u0111\u1ed9 \u0103n trong su\u1ed1t 5 n\u0103m qua?\u201d b\u1eb1ng 1 trong 4 l\u1ef1a ch\u1ecdn (i) kh\u00f4ng; (ii) c\u00f3, v\u00ec t\u00ecnh tr\u1ea1ng s\u1ee9c kh\u1ecfe; (iii) c\u00f3, v\u00ec l\u00fd do kh\u00e1c v\u00e0 (iv) kh\u00f4ng mu\u1ed1n tr\u1ea3 l\u1eddi. Ng\u01b0\u1eddi tham gia nghi\u00ean c\u1ee9u \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n m\u1eafc b\u1ec7nh th\u1eadn m\u1ea1n d\u1ef1a tr\u00ean m\u00e3 ch\u1ea9n \u0111o\u00e1n ICD \u2013 109<\/sup>.<\/p>\n\n\n\n

Sau khi x\u00e9t ti\u00eau ch\u00ed ch\u1ecdn v\u00e0 ti\u00eau ch\u00ed lo\u1ea1i tr\u1eeb, nghi\u00ean c\u1ee9u ch\u1ec9 s\u1eed d\u1ee5ng d\u1eef li\u1ec7u c\u1ee7a 465,288 ng\u01b0\u1eddi.<\/p>\n\n\n\n

\"\"<\/figure>\n\n\n\n

K\u1ebft qu\u1ea3 nghi\u00ean c\u1ee9u cho th\u1ea5y:<\/p>\n\n\n\n

    \n
  • Nh\u00f3m ng\u01b0\u1eddi tham gia nghi\u00ean c\u1ee9u c\u00f3 t\u1ea7n su\u1ea5t b\u1ed5 sung mu\u1ed1i v\u00e0o b\u1eefa \u0103n th\u01b0\u1eddng xuy\u00ean h\u01a1n c\u00f3 xu h\u01b0\u1edbng c\u00f3 ch\u1ec9 s\u1ed1 kh\u1ed1i c\u01a1 th\u1ec3 (BMI) cao h\u01a1n, c\u00f3 \u0111i\u1ec3m s\u1ed1 Townsend Deprivation Index cao h\u01a1n v\u00e0 \u0111\u1ed9 l\u1ecdc c\u1ea7u th\u1eadn (eGFR) gi\u1ea3m nhi\u1ec1u h\u01a1n so v\u1edbi nh\u00f3m ng\u01b0\u1eddi \u00edt khi b\u1ed5 sung mu\u1ed1i v\u00e0o b\u1eefa \u0103n.<\/li>\n\n\n\n
  • Nh\u1eefng ng\u01b0\u1eddi th\u01b0\u1eddng xuy\u00ean b\u1ed5 sung mu\u1ed1i v\u00e0o b\u1eefa \u0103n c\u0169ng c\u00f3 t\u1ef7 l\u1ec7 h\u00fat thu\u1ed1c, m\u1eafc \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng ho\u1eb7c b\u1ec7nh tim m\u1ea1ch c\u0169ng th\u01b0\u1eddng cao h\u01a1n.<\/li>\n\n\n\n
  • Nh\u1eefng ng\u01b0\u1eddi th\u01b0\u1eddng xuy\u00ean b\u1ed5 sung mu\u1ed1i v\u00e0o b\u1eefa \u0103n c\u0169ng c\u00f3 t\u1ef7 l\u1ec7 m\u1eafc b\u1ec7nh tim m\u1ea1ch cao h\u01a1n c\u00f3 \u00fd ngh\u0129a. C\u1ee5 th\u1ec3, so s\u00e1nh v\u1edbi nh\u00f3m ng\u01b0\u1eddi \u201ckh\u00f4ng bao gi\u1edd\/hi\u1ebfm khi\u201d th\u00eam mu\u1ed1i v\u00e0o b\u1eefa \u0103n, nh\u1eefng ng\u01b0\u1eddi \u201cthi tho\u1ea3ng\u201d th\u00eam mu\u1ed1i v\u00e0o b\u1eefa \u0103n c\u00f3 t\u1ef7 l\u1ec7 m\u1eafc b\u1ec7nh tim m\u1ea1ch cao h\u01a1n c\u00f3 \u00fd ngh\u0129a (HR 1.04, 1.00 – 1.07), nh\u1eefng ng\u01b0\u1eddi \u201cth\u01b0\u1eddng xuy\u00ean\u201d b\u1ed5 sung mu\u1ed1i v\u00e0o b\u1eefa \u0103n c\u00f3 t\u1ef7 l\u1ec7 m\u1eafc b\u1ec7nh tim m\u1ea1ch cao h\u01a1n c\u00f3 \u00fd ngh\u0129a (HR 1.07, 1.02 \u2013 1.11), nh\u1eefng ng\u01b0\u1eddi \u201clu\u00f4n lu\u00f4n\u201d b\u1ed5 sung mu\u1ed1i v\u00e0o b\u1eefa \u0103n c\u00f3 t\u1ef7 l\u1ec7 m\u1eafc b\u1ec7nh tim m\u1ea1ch cao h\u01a1n c\u00f3 \u00fd ngh\u0129a (HR 1.11, 1.05 \u2013 1.18)9<\/sup>.<\/li>\n<\/ul>\n\n\n\n

    B\u00e0n lu\u1eadn<\/strong><\/p>\n\n\n\n

    Nh\u01b0 v\u1eady, nghi\u00ean c\u1ee9u n\u00e0y \u0111\u00e3 cung c\u1ea5p b\u1eb1ng ch\u1ee9ng kh\u1eb3ng \u0111\u1ecbnh t\u1ea7n su\u1ea5t b\u1ed5 sung mu\u1ed1i v\u00e0o th\u1ee9c \u0103n c\u00f3 li\u00ean quan \u0111\u1ebfn nguy c\u01a1 tim m\u1ea1ch t\u0103ng \u1edf nh\u00f3m d\u00e2n s\u1ed1 b\u00ecnh th\u01b0\u1eddng (kh\u00f4ng m\u1eafc t\u0103ng huy\u1ebft \u00e1p hay \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng). K\u1ebft qu\u1ea3 nghi\u00ean c\u1ee9u n\u00e0y g\u1ee3i \u00fd r\u1eb1ng vi\u1ec7c h\u1ea1n ch\u1ebf b\u1ed5 sung mu\u1ed1i v\u00e0o th\u1ee9c \u0103n c\u00f3 th\u1ec3 l\u00e0 chi\u1ebfn l\u01b0\u1ee3c ph\u00f2ng ng\u1eeba nguy c\u01a1 m\u1eafc b\u1ec7nh th\u1eadn m\u1ea1n hi\u1ec7u qu\u1ea3.<\/p>\n\n\n\n

    \n\n\n\n

    T\u00e0i li\u1ec7u tham kh\u1ea3o<\/strong><\/p>\n\n\n\n

      \n
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    2. Aburto NJ, Ziolkovska A, Hooper L, Elliott P, Cappuccio FP, Meerpohl JJ. Effect of lower sodium intake on health: systematic review and meta-analyses. BMJ. 2013;346:f1326. doi:10.1136\/bmj.f1326<\/li>\n\n\n\n
    3. Ravera M, Re M, Deferrari L, Vettoretti S, Deferrari G. Importance of blood pressure control in chronic kidney disease.J Am Soc Nephrol. 2006;17(4)(suppl 2):S98-S103. doi:10.1681\/ASN.2005121319<\/li>\n\n\n\n
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    5. Townsend RR, Taler SJ. Management of hypertension in chronic kidney disease. Nat Rev Nephrol. 2015;11(9): 555-563. doi:10.1038\/nrneph.2015.114<\/li>\n\n\n\n
    6. Grillo A, Salvi L, Coruzzi P, Salvi P, Parati G. Sodium intake and hypertension. Nutrients. 2019;11(9):1970. doi:10. 3390\/nu11091970<\/li>\n\n\n\n
    7. Aaron KJ, Campbell RC, Judd SE, Sanders PW, Muntner P. Association of dietary sodium and potassium intakes with albuminuria in normal-weight, overweight, and obese participants in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study. Am J Clin Nutr. 2011;94(4):1071-1078. doi:10.3945\/ajcn.111.013094<\/li>\n\n\n\n
    8. Thomas MC, Moran J, Forsblom C, et al; FinnDiane Study Group. The association between dietary sodium intake, ESRD, and all-cause mortality in patients with type 1 diabetes. Diabetes Care. 2011;34(4):861-866. doi:10. 2337\/dc10-1722<\/li>\n\n\n\n
    9. Tang R, Kou M, Wang X, Ma H, Li X, Heianza Y, Qi L. Self-Reported Frequency of Adding Salt to Food and Risk of Incident Chronic Kidney Disease. JAMA Netw Open. 2023 Dec 1;6(12):e2349930. doi: 10.1001\/jamanetworkopen.2023.49930.<\/li>\n\n\n\n
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    12. Wang X, Ma H, Kou M, et al. Dietary sodium intake and risk of incident type 2 diabetes. Mayo Clin Proc. 2023; 98(11):1641-1652. doi:10.1016\/j.mayocp.2023.02.029<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"

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