Abstract:Fragility fracture impairs the activities of daily living and quality of life of the elderly. Accumulating evidence has shown that patients with osteoporosis have an increased all-cause mortality as well as cardiovascular mortality rates. Osteoporosis and cardiovascular diseases have common risk factors, such as diabetes mellitus. Patients with diabetes have an increased risk of osteoporosis; thus, diabetes-related bone disease is now recognized as one of the complications of diabetes. Although accumulation of advanced glycation end products and oxidative stress are associated with the formation and progression of atherosclerosis, these are reported to be involved in the pathogenesis of osteoporosis, especially in diabetic patients. Moreover, recent studies have shown that osteocalcin, which is secreted from the bone into the circulation, has an endocrine function of regulating glucose and energy metabolism. In addition, osteocalcin directly affects vascular endothelial cells and smooth muscle cells and protects against oxidative stress-induced cell dysfunction. Therefore, the bone-vascular axis attracts widespread attention. In this review, I described the association between bone and glucose metabolism and vascular failure on the basis of recent evidence.