Abstract
IntroductionIn response to the ongoing debate over the relationship between the use of statins and the risk of Parkinson's disease (PD), we performed a systematic review and meta-analysis of observational studies to examine their association.MethodsWe conducted a review of the literature using electronic databases supplemented by a manual search to identify potentially relevant case-control or cohort studies. Summary relative risk (RRs) and 95% confidence intervals (CIs) were calculated using a random-effects model. Sensitivity and subgroup analyses were also conducted.ResultsEleven studies (five case-control and six cohort) with a total of 3,513,209 participants and 21,011 PD cases were included. Statin use was associated with a lower risk of PD, with a summary RR of 0.81 (95% CI 0.71–0.92). Sensitivity analysis demonstrated the robustness of results. Subgroup analyses showed that neither study design nor study region significantly influenced the effect estimates. However, subgroup studies adjusted for age or sex had a greater inverse association than did unadjusted analyses (age-adjusted RR 0.75, 95% CI 0.60–0.95; age-unadjusted RR 0.86, 95% CI 0.75–0.99 and sex-adjusted RR 0.76, 95% CI 0.59–0.98; sex-unadjusted RR 0.85, 95% CI 0.79–0.92).ConclusionsResults of this systematic review suggest that statin use is associated with a reduced PD risk. However, randomized controlled trials and more observational studies should be performed before strong conclusions are drawn.
Highlights
In response to the ongoing debate over the relationship between the use of statins and the risk of Parkinson's disease (PD), we performed a systematic review and meta-analysis of observational studies to examine their association
Statin use was associated with a lower risk of PD, with a summary relative risk (RRs) of 0.81
Results of this systematic review suggest that statin use is associated with a reduced PD risk
Summary
We conducted a review of the literature using electronic databases supplemented by a manual search to identify potentially relevant case-control or cohort studies. Summary relative risk (RRs) and 95% confidence intervals (CIs) were calculated using a random-effects model. We combined case-control and cohort studies and calculated the summary RRs and 95% CIs. We assessed heterogeneity among studies using the Cochrane's Q test and I2 statistics. For the Q test, a p value < 0.10 was considered to indicate significant heterogeneity, while for I2, a value of 0%–25% represented insignificant heterogeneity, a value > 25% but 50% represented low heterogeneity, a value > 50% but 75% represented moderate heterogeneity, and a value > 75% represented high heterogeneity [20]. In cases of moderate heterogeneity, summary RRs were calculated using the random-effects model (DerSimonian and Laird method), which allowed each of the studies in the meta-analysis to estimate a different effect size. We used the results of the original studies from multivariate models with the most complete adjustment for potential confounders
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