Wang Peifu, Li Jilai, Qiu Shi, Wen Honfeng, Du Jichen
Department of Neurology, Aerospace Center Hospital, Peking University Aerospace Clinical College, Beijing, People's Republic of China.
Neuropsychiatr Dis Treat. 2014 Dec 31;11:59-66. doi: 10.2147/NDT.S69918. eCollection 2015.
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.
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.
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).
In summary, our results of meta-analysis do not support a protective role of HRT in female PD development.
关于激素替代疗法（HRT）与帕金森病（PD）关系的已发表数据尚无定论。因此，进行了一项观察性研究的系统荟萃分析以阐明该主题。
检索了PubMed和EMBASE数据库中截至2014年6月2日发表的病例对照或队列研究。使用随机效应模型估计相对风险（RRs）及其95%置信区间（CIs）的荟萃分析。
我们的荟萃分析最终共纳入了10项病例对照研究和4项队列研究。曾经使用过HRT的女性与从未使用过HRT的女性相比，患PD的总体合并RR为1.00（95%CI：0.84 - 1.20）。仅限于仅使用雌激素的受试者，也发现了类似趋势（RR：0.95，95%CI：0.69 - 1.30）。在按研究设计进行的亚组分析中，病例对照研究未观察到显著关联（RR：0.79，95%CI：0.62 - 1.02），而队列研究中发现了正相关（RR：1.24，95%CI：1.10 - 1.40）。根据研究质量进行的进一步分析中，低质量组发现了负相关（RR：0.58，95%CI：0.40 - 0.82），而高质量组发现了正相关（RR：1.16，95%CI：1.02 - 1.31）。
总之，我们的荟萃分析结果不支持HRT在女性PD发生发展中具有保护作用。
