title: Statin Use and the Risk of Parkinson's Disease: An Updated Meta-Analysis.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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. Sensitivity and subgroup analyses were also conducted.
  
  
  RESULTS
  Eleven 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).
  
  
  CONCLUSIONS
  Results 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.
authors.affiliation: Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
authors.forename: Shuang
authors.initials: S
authors.lastname: Bai
authors.affiliation: Department of Ultrasound, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Song
authors.affiliation: Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Huang
authors.affiliation: Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
authors.forename: Lidan
authors.initials: L
authors.lastname: Peng
authors.affiliation: Department of Orthopedics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Jia
authors.affiliation: Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
authors.forename: Hong
authors.initials: H
authors.lastname: Lu
mesh_terms: D016022:Case-Control Studies; D015331:Cohort Studies; D016208:Databases, Factual; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects*; D006949:Hyperlipidemias / Q000188:drug therapy; D010300:Parkinson Disease / Q000209:etiology*; D012306:Risk
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors