title: Exogenous and endogenous hormones in relation to glioma in women: a meta-analysis of 11 case-control studies.
abstract: OBJECTIVE
  Previous investigations of glioma risk in women have focused on oral contraceptive (OC), hormone replacement therapy (HRT), and reproductive factors. However, the results of published studies were inconclusive and inconsistent. Thus, a meta-analysis based on published case-control studies was performed to assess the role of exogenous and endogenous hormones factors in glioma risk.
  
  
  METHODS
  The PubMed and EMBASE databases were searched without any restrictions on language or publication year. Reference lists from retrieved articles were also reviewed. We included case-control studies reporting relative risks (RRs) with corresponding 95% confidence intervals (CIs) (or data to calculate them) between oral contraceptive (OC) and hormone replacement therapy (HRT) use, reproductive factors and glioma. Random-effects models were used to calculate the summary risk estimates.
  
  
  RESULTS
  Finally, 11 eligible studies with 4860 cases and 14,740 controls were identified. A lower risk of glioma was observed among women who were ever users of exogenous hormones (OC RR = 0.707, 95% CI = 0.604-0.828; HRT: RR = 0.683, 95% CI = 0.577-0.808) compared with never users. An increased glioma risk was associated with older age at menarche (RR = 1.401, 95% CI = 1.052-1.865). No association was observed for menopause status, parous status, age at menopause, or age at first birth and glioma risk.
  
  
  CONCLUSIONS
  The results of our study support the hypothesis female sex hormones play a role in the development of glioma in women. Additional studies are warranted to validate the conclusion from this meta-analysis and clarity the underlying mechanisms.
authors.affiliation: Department of Neurosurgery, First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China. qizhenyu@suda.edu.cn
authors.forename: Zhen-Yu
authors.initials: ZY
authors.lastname: Qi
authors.forename: Chuan
authors.initials: C
authors.lastname: Shao
authors.forename: Xin
authors.initials: X
authors.lastname: Zhang
authors.forename: Guo-Zhen
authors.initials: GZ
authors.lastname: Hui
authors.forename: Zhong
authors.initials: Z
authors.lastname: Wang
mesh_terms: D000367:Age Factors; D016022:Case-Control Studies; D003276:Contraceptives, Oral / Q000009:adverse effects; D005260:Female; D005910:Glioma / Q000453:epidemiology* / Q000209:etiology / Q000378:metabolism*; D012739:Gonadal Steroid Hormones / Q000378:metabolism*; D020249:Hormone Replacement Therapy / Q000009:adverse effects; D006801:Humans; D008572:Menarche
chemical_list: D003276:Contraceptives, Oral; D012739:Gonadal Steroid Hormones