Objective. The purpose of this study was determination the role of gene COL1A1 polymorphism in postmenopausal osteoporosis, namely - to study influence of genotypes and allelic distribution on indexes, characterizing of the osteoporotic skeleton changes, maintenances in blood of macronutrients (calcium and phosphorus), hormones and proinflammatory cytokines.Materials and methods. Study is undertaken at 74 menopausal women in age 46-65 years (on STROW classification +1а and +1b). On the T-criterion of twophotonic x-rayed absorptiometry and clinical data established the presence of osteoporotic changes (T-criterion >-1 SD; group of cases; n=44) or their absence (T-criterion ≤-1 SD; n=30). In blood determined the row of biochemical, hormonal and immunological indexes. The analysis of polymorphic DNA-locus rs1800012 (G+1245T, Sp1) gene of COL1A1 was carried out with the use of compatible test-system «Osteogene-M» (LTD «GENE», RF).Results and discussion. In gene COL1A1 polymorphism rs1800012 (G+1245T; Sp1) the homozygous genotype (T/T), that met in 2,6 times more often, prevailed at presence of osteoporotic skeleton changes. Accordingly, frequency increased minor allele (T) - in 2,2 time (p(Fet)=0,006), the presence of that promoted the risk of osteoporotic skeleton changes development (OR=3,97; CI=1,45-10,88; р (χ2) =0,006) and was associated with reduction of mineral closeness of bone, increase of blood levels phosphorus, parathyroid hormone, osteocalcine, triiodthyronine, proinflammatory cytokine 1β and by the decline of progesterone level.Conclusions. Thus, it was shown that polymorphism of rs1800012 (G+1245T; Sp1) COL1A1 gene, resulting in violation of collagen 1 type structure and straight assisted the structure bone fabric change due to development of hyperparathyroidism, hypogonadism and inflammatory reactions. In a high-risk group on postmenopausal osteoporosis development it is necessary to include women at presence of minor llele (Т) of this polymorphism, which increases the risk of postmenopausal osteoporotic skeleton changes in four times.