Background: It is well known that both bone loss and vascular calcification are an age-related process. We analyzed the interactions between bone mineral density (BMD) and coronary artery calcium score (CACS). Methods and Results: Between March 2009 and February 2011, 1259 subjects (mean age:54.7짹10.0 years) who visited the Heath Promotion Center of the Catholic University Seoul St. Mary���s Hospital for a routine health check-up were enrolled. We estimated BMD by dual energy X-ray absorptionmetry (DEXA) and CACS by 64-channel dual source CT (DSCT). In 570 female subjects, there was an inverse correlation between BMD and CACS (lumbar spine, r=-0.107, p=0.002; femur, r=-0.127, p=0.002, respectively), but not related to BMD (lumbar spine, r=0.008, p=0.842; femur, r=-0.030, p=0.430, respectively) in 689 male subjects. According to T-score on DEXA, male subjects were categorized into 3 groups: normal (T-score > -1.0); osteopenia (-2.5 < T-score ��� -1.0); and osteoporosis (T-score ��� -2.5). CACS showed a significant increase in osteopenia greater than normal group (96.21짹309.56 vs. 44.91짹132.42, p=0.010), but did not show a significant difference between osteopenia and osteporosis group (96.21짹309.56 vs. 51.14짹132.85, p=0.173) in male subjects. Age in male [odds ratio(OR): 1.055 (95% confidence interval(CI): 1.029-1.081), p< 0.001] and menopause in female subjects [OR: 17.692 (95%CI: 8.530-36.696), p< 0.001] was independently associated with the osteopenia, earlier bone loss, respectively. Conclusion: Our results suggest that there are clear gender differences in between earlier bone loss and vascular calcification by the acceleration of in the natural aging process.