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The  Apa I polymorphism (G &gt; T, rs7975232) of the vitamin D receptor ( VDR ) gene in the risk of postmenopausal osteoporosis has been widely researched, and the results have yielded conflicts. Therefore, we performed an updated pooled analysis to comprehensively assess the association between  VDR Apa I polymorphism and postmenopausal osteoporosis risk. We searched eligible studies about  Apa I polymorphism and osteoporosis through the PubMed, Embase, CNKI and Wanfang databases; case–control studies containing available genotype frequencies of A/a were chosen. We used the odds ratio with 95% confidence interval to assess the strength of this association. Sensitivity analysis and publication bias assessment were performed. Trial sequential analysis (TSA) was performed to evaluate a sufficient sample. Twenty-two studies assessed the relationship between  Apa I polymorphism and the risk of osteoporosis in postmenopausal women. The comprehensive analyses showed no significant association for  Apa I polymorphism with postmenopausal osteoporosis in the overall population, equally valid for Asian and Caucasian subgroups with any genetic model. TSA still indicated the results were robust. The present meta-analysis suggests that the  VDR Apa I genotype may not affect the risk of postmenopausal osteoporosis in Asians and Caucasians.

VDR gene Apa I polymorphism and risk of postmenopausal osteoporosis: a meta-analysis from 22 studies