An effort was made to establish an order made medical system for management of osteoporosis. A T --> C polymorphism in exon 1 of the transforming growth factor-beta 1 gene, which is associated with the rate of bone loss as well as the response to active vitamin D treatment, was used to select high responder to active vitamin D treatment. We also determined serum level of 25 hydroxy-vitamin D to evaluate a degree of vitamin D deficiency. Based on these data, we categorized patients into four groups ; high responder with vitamin D deficiency to whom 1 microg/day active vitamin D was administered, high responder without vitamin D deficiency or low responder with vitamin D deficiency to whom 0.5 microg/day active vitamin D was administered, and low responder without vitamin D deficiency to whom no drug was given. The patients have been checked up every 6 months with regard to changes in bone mineral density and occurrence of fresh fractures. So far, it was found that the SNP is associated with prevalent vertebral fractures ; the frequency of the T allele was significantly greater in patients with vertebral fractures, indicating that the SNP can predict the fracture risk.