Forkhead box transcription factor O3 affects bone metabolism and participates in the pathological processes of various bone-related diseases

• FoxO3a regulates bone metabolism by modulating oxidative stress and autophagy in bone cells, influencing proliferation, differentiation, and apoptosis. • FoxO3a promotes osteogenic differentiation of bone marrow mesenchymal stem cells and osteoprogenitor cells via autophagy activation, while inhibiting osteoclastogenesis. • FoxO3a protects osteocytes and chondrocytes from oxidative stress and senescence, reducing bone loss and osteoarthritis progression. • FoxO3a is implicated in the pathology of osteoporosis, osteoarthritis, osteonecrosis of the femoral head, and malignant bone tumors, making it a potential therapeutic target.