BsmI, TaqI, ApaI and FokI polymorphisms in the vitamin D receptor (VDR) gene and risk of fracture in Caucasians: a meta-analysis.

CONTEXT: Vitamin D receptor (VDR) gene polymorphisms have been strongly associated with bone mineral density in some studies. However, in a recent meta-analysis, no relationship of the VDR BsmI or TaqI polymorphism and fracture risk was found in the meta-analysis of published data. OBJECTIVE AND
DESIGN: Our meta-analysis studied whether a relationship exists between BsmI, TaqI, ApaI and FokI polymorphisms in the VDR gene and risk of fracture. DATA SOURCES: Relevant studies were identified from the following electronic databases: MEDLINE, EMBASE and Current Contents before January 2010. DATA SYNTHESIS: This meta-analysis included 17 studies with a total of 21 eligible comparisons, which included 2112 fracture cases and 4521 controls. All of these studies reported on Caucasians. The combined results based on all studies showed that fracture cases had a significantly lower frequency of bb genotype of BsmI [odds ratio (OR) = 0.87, 95% confidence interval (CI)=0.76, 0.98]. When stratifying by fracture type, we found that (1) hip fracture cases had a significantly lower frequency of bb genotype of BsmI (OR=0.82, 95% CI=0.70, 0.97); (2) hip fracture cases had a significantly lower frequency of Tt genotype of TaqI (OR=0.65, 95% CI=0.43, 0.97); (3) hip fracture cases had a significantly higher frequency of tt genotype of TaqI (OR=1.74, 95% CI=1.05, 2.91); (4) vertebral fracture cases had a significantly higher frequency of Aa genotype of ApaI (OR=1.63, 95% CI=1.03, 2.59). No significant difference was found in any genotype of FokI.
CONCLUSION: Our meta-analysis suggests that there is a modest but statistically significant association between the BsmI bb genotypes and fracture. Copyright 2010 Elsevier Inc. All rights reserved.