使用可穿戴活动追踪器监测甲状腺毒症患者静息心率的临床可行性：前瞻性纵向观察研究
Clinical Feasibility of Monitoring Resting Heart Rate Using a Wearable Activity Tracker in Patients With Thyrotoxicosis: Prospective Longitudinal Observational Study.
作者信息
Lee Jie-Eun, Lee Dong Hwa, Oh Tae Jung, Kim Kyoung Min, Choi Sung Hee, Lim Soo, Park Young Joo, Park Do Joon, Jang Hak Chul, Moon Jae Hoon
机构信息
Department of Internal Medicine, Seoul National University Healthcare System Gangnam Center, Seoul, Republic Of Korea.
Department of Internal Medicine, Seoul National University Bundang Hospital, Sungnam-si, Republic Of Korea.
出版信息
JMIR Mhealth Uhealth. 2018 Jul 13;6(7):e159. doi: 10.2196/mhealth.9884.
BACKGROUND
Symptoms and signs of thyrotoxicosis are nonspecific and assessing its clinical status is difficult with conventional physical examinations and history taking. Increased heart rate (HR) is one of the easiest signs to quantify this, and current wearable devices can monitor HR.
OBJECTIVE
We assessed the association between thyroid function and resting HR measured by a wearable activity tracker (WD-rHR) and evaluated the clinical feasibility of using this method in patients with thyrotoxicosis.
METHODS
Thirty patients with thyrotoxicosis and 10 controls were included in the study. Participants were instructed to use the wearable activity tracker during the study period so that activity and HR data could be collected. The primary study outcomes were verification of changes in WD-rHR during thyrotoxicosis treatment and associations between WD-rHR and thyroid function. Linear and logistic model generalized estimating equation analyses were performed and the results were compared to conventionally obtained resting HR during clinic visits (on-site resting HR) and the Hyperthyroidism Symptom Scale.
RESULTS
WD-rHR was higher in thyrotoxic patients than in the control groups and decreased in association with improvement of thyrotoxicosis. A one standard deviation-increase of WD-rHR of about 11 beats per minute (bpm) was associated with the increase of serum free T4 levels (beta=.492, 95% CI 0.367-0.616, P<.001) and thyrotoxicosis risk (odds ratio [OR] 3.840, 95% CI 2.113-6.978, P<.001). Although the Hyperthyroidism Symptom Scale showed similar results with WD-rHR, a 1 SD-increase of on-site rHR (about 16 beats per minute) showed a relatively lower beta and OR (beta=.396, 95% CI 0.204-0.588, P<.001; OR 2.114, 95% CI 1.365-3.273, P<.001) compared with WD-rHR.
CONCLUSIONS
Heart rate data measured by a wearable device showed reasonable predictability of thyroid function. This simple, easy-to-measure parameter is clinically feasible and has the potential to manage thyroid dysfunction.
TRIAL REGISTRATION
ClinicalTrials.gov NCT03009357; https://clinicaltrials.gov/ct2/show/NCT03009357 (Archived by WebCite at http://www.webcitation.org/70h55Llyg).
背景
甲状腺毒症的症状和体征不具有特异性，通过传统体格检查和病史采集来评估其临床状态较为困难。心率增加是量化此情况最容易的体征之一，当前的可穿戴设备能够监测心率。
目的
我们评估了甲状腺功能与可穿戴活动追踪器测量的静息心率（WD-rHR）之间的关联，并评估了在甲状腺毒症患者中使用该方法的临床可行性。
方法
本研究纳入了30例甲状腺毒症患者和10例对照者。研究期间，指导参与者使用可穿戴活动追踪器，以便收集活动和心率数据。主要研究结果是验证甲状腺毒症治疗期间WD-rHR的变化以及WD-rHR与甲状腺功能之间的关联。进行线性和逻辑模型广义估计方程分析，并将结果与门诊就诊时常规获得的静息心率（现场静息心率）和甲状腺功能亢进症状量表进行比较。
结果
甲状腺毒症患者的WD-rHR高于对照组，且随着甲状腺毒症的改善而降低。WD-rHR每增加一个标准差（约每分钟11次心跳）与血清游离T4水平升高（β=0.492，95%CI 0.367-0.616，P<0.001）和甲状腺毒症风险增加（比值比[OR]3.840，95%CI 2.113-6.978，P<0.001）相关。尽管甲状腺功能亢进症状量表与WD-rHR显示出相似的结果，但现场静息心率每增加1个标准差（约每分钟16次心跳）显示出相对较低的β值和OR值（β=0.396，95%CI 0.204-0.588，P<0.001；OR 2.114，95%CI 1.365-3.273，P<0.001），与WD-rHR相比。
结论
可穿戴设备测量的心率数据显示出对甲状腺功能具有合理的预测性。这个简单、易于测量的参数在临床上是可行的，并且有管理甲状腺功能障碍的潜力。
试验注册
ClinicalTrials.gov NCT03009357；https://clinicaltrials.gov/ct2/show/NCT03009357（由WebCite存档于http://www.webcitation.org/70h55Llyg）
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