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Hormone replacement therapy and Parkinson's disease risk in women: a meta-analysis of 14 observational studies.

Wang P, Li J, Qiu S, Wen H, Du J - Neuropsychiatr Dis Treat (2014)

Bottom Line: In the subgroup analysis by study design, no significant association was observed in case-control studies (RR: 0.79, 95% CI: 0.62-1.02), whereas a positive association was found in cohort studies (RR: 1.24, 95% CI: 1.10-1.40).In further analysis according to study quality, an inverse association was found in the low-quality group (RR: 0.58, 95% CI: 0.40-0.82), whereas a positive association was found in the high-quality group (RR: 1.16, 95% CI: 1.02-1.31).In summary, our results of meta-analysis do not support a protective role of HRT in female PD development.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurology, Aerospace Center Hospital, Peking University Aerospace Clinical College, Beijing, People's Republic of China.

ABSTRACT

Background and purpose: Published data on the relationship of hormone replacement therapy (HRT) with Parkinson's disease (PD) were inconclusive. Thus, a systematic meta-analysis of observational studies was performed to clarify this topic.

Methods: The databases of PubMed and EMBASE were searched for case-control or cohort studies published up till June 2, 2014. Meta-analysis of the relative risks (RRs) with 95% confidence intervals (CIs) was estimated using random-effects models.

Results: A final total of ten case-control and four cohort studies were included in our meta-analysis. The overall combined RR of PD for ever users versus never users of HRT was 1.00 (95% CI: 0.84-1.20). Limited to those subjects who only use estrogen, a similar trend was detected (RR: 0.95, 95% CI: 0.69-1.30). In the subgroup analysis by study design, no significant association was observed in case-control studies (RR: 0.79, 95% CI: 0.62-1.02), whereas a positive association was found in cohort studies (RR: 1.24, 95% CI: 1.10-1.40). In further analysis according to study quality, an inverse association was found in the low-quality group (RR: 0.58, 95% CI: 0.40-0.82), whereas a positive association was found in the high-quality group (RR: 1.16, 95% CI: 1.02-1.31).

Conclusion: In summary, our results of meta-analysis do not support a protective role of HRT in female PD development.

No MeSH data available.


Related in: MedlinePlus

Sensitivity analyses for HRT and PD risk.Abbreviations: CI, confidence interval; HRT, hormone replacement therapy; PD, Parkinson’s disease.
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f3-ndt-11-059: Sensitivity analyses for HRT and PD risk.Abbreviations: CI, confidence interval; HRT, hormone replacement therapy; PD, Parkinson’s disease.

Mentions: Sensitivity analyses were performed to evaluate the effect of one single study on the overall estimate by sequentially excluding each study at one time. The sensitivity analyses suggested that the overall result was robust (Figure 3). A publication bias was identified using Egger’s linear regression test (P=0.013). Then, the trim-and-fill method, which estimates the number of potential missing studies resulting from publication bias, was also implemented.28 This method identified any possible missing studies; the adjustment-estimated RR with corresponding 95% CI was not changed, indicating that our result was stable.


Hormone replacement therapy and Parkinson's disease risk in women: a meta-analysis of 14 observational studies.

Wang P, Li J, Qiu S, Wen H, Du J - Neuropsychiatr Dis Treat (2014)

Sensitivity analyses for HRT and PD risk.Abbreviations: CI, confidence interval; HRT, hormone replacement therapy; PD, Parkinson’s disease.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4317144&req=5

f3-ndt-11-059: Sensitivity analyses for HRT and PD risk.Abbreviations: CI, confidence interval; HRT, hormone replacement therapy; PD, Parkinson’s disease.
Mentions: Sensitivity analyses were performed to evaluate the effect of one single study on the overall estimate by sequentially excluding each study at one time. The sensitivity analyses suggested that the overall result was robust (Figure 3). A publication bias was identified using Egger’s linear regression test (P=0.013). Then, the trim-and-fill method, which estimates the number of potential missing studies resulting from publication bias, was also implemented.28 This method identified any possible missing studies; the adjustment-estimated RR with corresponding 95% CI was not changed, indicating that our result was stable.

Bottom Line: In the subgroup analysis by study design, no significant association was observed in case-control studies (RR: 0.79, 95% CI: 0.62-1.02), whereas a positive association was found in cohort studies (RR: 1.24, 95% CI: 1.10-1.40).In further analysis according to study quality, an inverse association was found in the low-quality group (RR: 0.58, 95% CI: 0.40-0.82), whereas a positive association was found in the high-quality group (RR: 1.16, 95% CI: 1.02-1.31).In summary, our results of meta-analysis do not support a protective role of HRT in female PD development.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurology, Aerospace Center Hospital, Peking University Aerospace Clinical College, Beijing, People's Republic of China.

ABSTRACT

Background and purpose: Published data on the relationship of hormone replacement therapy (HRT) with Parkinson's disease (PD) were inconclusive. Thus, a systematic meta-analysis of observational studies was performed to clarify this topic.

Methods: The databases of PubMed and EMBASE were searched for case-control or cohort studies published up till June 2, 2014. Meta-analysis of the relative risks (RRs) with 95% confidence intervals (CIs) was estimated using random-effects models.

Results: A final total of ten case-control and four cohort studies were included in our meta-analysis. The overall combined RR of PD for ever users versus never users of HRT was 1.00 (95% CI: 0.84-1.20). Limited to those subjects who only use estrogen, a similar trend was detected (RR: 0.95, 95% CI: 0.69-1.30). In the subgroup analysis by study design, no significant association was observed in case-control studies (RR: 0.79, 95% CI: 0.62-1.02), whereas a positive association was found in cohort studies (RR: 1.24, 95% CI: 1.10-1.40). In further analysis according to study quality, an inverse association was found in the low-quality group (RR: 0.58, 95% CI: 0.40-0.82), whereas a positive association was found in the high-quality group (RR: 1.16, 95% CI: 1.02-1.31).

Conclusion: In summary, our results of meta-analysis do not support a protective role of HRT in female PD development.

No MeSH data available.


Related in: MedlinePlus