Abstract
Background: Estrogen replacement therapy (ERT) is a common treatment method for menopausal syndrome; however, its therapeutic value for the treatment of neurological diseases is still unclear. Epidemiological studies were performed, and the effect of postmenopausal ERT on treating neurodegenerative diseases, including Alzheimer's disease (AD) and Parkinson's disease (PD), was summarized through a meta-analysis.Methods: Twenty-one articles were selected using a systematic searching of the contents listed on PubMed and Web of Science before June 1, 2019. Epidemiological studies were extracted, and relevant research data were obtained from the original articles based on the predefined inclusion criteria and data screening principles. The Comprehensive Meta-Analysis Version 2 software was used to pool effective size, test heterogeneity, conduct meta-regression and subgroup analysis, and to calculate publication bias.Results: Our results showed that ERT significantly decreased the risk of onset and/or development of AD [odds ratio (OR): 0.672; 95% CI: 0.581–0.779; P < 0.001] and PD (OR: 0.470; 95% CI: 0.368–0.600; P < 0.001) compared with the control group. A subgroup and meta-regression analysis showed that study design and measure of effect were the source of heterogeneity. Age, sample size, hormone therapy ascertainment, duration of the treatment, or route of administration did not play a significant role in affecting the outcome of the meta-analysis.Conclusion: We presented evidence here to support the use of estrogen therapy for the treatment of AD and PD.
Highlights
Neurodegenerative diseases, such as Alzheimer’s disease (AD) and Parkinson’s disease (PD), are characterized by the sustained cell cycle arrest and production of a continuous senescence-associated secretory phenotype due to structural and functional changes in neurons (Kritsilis et al, 2018)
Stratification of neurological disorders: five cases evaluated the impact of Estrogen replacement therapy (ERT) on PD and 16 cases on AD
All studies were included in this review except one reported using standard criteria to diagnose AD and dementia [e.g., National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer’s Disease and Related Disorders Association (NINCDS-ADRDA); Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised (DSM-III-R); Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSMIV); or Movement Disorder Society-Sponsored Revision Unified PD Rating Scale (MDS-UPDRS)]
Summary
Neurodegenerative diseases, such as Alzheimer’s disease (AD) and Parkinson’s disease (PD), are characterized by the sustained cell cycle arrest and production of a continuous senescence-associated secretory phenotype due to structural and functional changes in neurons (Kritsilis et al, 2018). To AD in terms of incidence, PD is the second most common neurodegenerative disease and is characterized by the progressive damage of mesencephalic dopaminergic (DA) neurons of the substantia nigra (SN) and the striatal projections. Estrogen replacement therapy (ERT) is a common treatment method for menopausal syndrome; its therapeutic value for the treatment of neurological diseases is still unclear. Epidemiological studies were performed, and the effect of postmenopausal ERT on treating neurodegenerative diseases, including Alzheimer’s disease (AD) and Parkinson’s disease (PD), was summarized through a meta-analysis
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