Over the last several years, scientists from many disciplines have contributed to an astonishing increase in our understanding of the epidemiology and pathogenesis of vitamin D–related diseases, as well as to the development of appropriate treatment strategies for these diseases. These advances have greatly lowered the incidence and prevalence of rickets and osteomalacia, the diseases traditionally associated with vitamin D deficiency. However, a growing body of evidence has emerged indicating that less severe degrees of vitamin D deficiency (vitamin D insufficiency) may impair gastrointestinal absorption of calcium and contribute to the evolution of osteoporosis in older populations. In addition, many diverse studies have implicated vitamin D and its metabolites in the pathogenesis of a wide variety of clinically important nonskeletal diseases, such as cardiovascular disease and several common forms of cancer. These studies have helped to establish that vitamin D insufficiency/deficiency may underlie a heterogeneous group of disorders and is reaching near epidemic proportions in Western populations. However, despite these many advances, there exist many unresolved controversies regarding appropriate diagnostic criteria and treatment for both skeletal and nonskeletal vitamin D–related diseases.
The American Society For Bone and Mineral Research (ASBMR) believes that the recent scientific progress and momentum in the field of vitamin D research, the rapid growth and diversification of the field, the confusion regarding serum measurements of vitamin D metabolites, the definition of vitamin D–related disease states, the appropriate use of vitamin D therapy, and the enormous public health and fiscal ramifications of vitamin D–related diseases make this an important time to bring together the experts from around the world who work in this important area. To that end, ASBMR convened a conference on the Contemporary Diagnosis and Treatment of Vitamin D–Related Disorders, which met on December 4–5, 2006.
The goals of the meeting were to:
- 1.Bring together clinical and basic investigators working in this field and staff from the many interested institutes within the NIH to brainstorm regarding the progress of their individual laboratories and to think collectively about the directions this field should take in the future.
- 2.Encourage open discussion regarding the controversies in the vitamin D field, to develop scientific approaches to resolve these controversies, and to facilitate development of a reliable knowledge base. We believe that these interdisciplinary discussions will facilitate translational research and transfer of information to the clinical arena.
- 3.Attract new, young investigators in the field and sustain their research by allowing them to meet and interact with the senior thought leaders in the field.
- 4.Increase public awareness of exciting potential benefits to patients with vitamin D–related diseases in the intermediate term and of the need to support future research in this area to advance public health.
We hope that, as a consequence of the information presented and the goals defined at the meeting, basic and clinical scientists and NIH staff will develop strategies for funding future studies to advance the field.
The field of vitamin D research encompasses an array of scientific disciplines that range from basic science to animal physiology to early and late clinical trials. We believe that we are in the early phases of the process of redefining the role of vitamin D in a diverse group of diseases and of refining the treatment strategies for these disorders. This adds urgency to efforts to pursue further research advances, clarify recent discoveries and disseminate scientific advances so that uniform guidelines can be developed and brought to the clinical arena as quickly as possible to advance the diagnosis and treatment of these disorders.
The manuscripts that follow were submitted by the basic and clinical scientists who addressed the conference. They summarize contemporary information about the scientific basis underlying the evolving database regarding the role of vitamin D in the pathogenesis of various and diverse diseases and highlight, where possible, unresolved controversies in this burgeoning field. A research agenda, proposed by conference organizers, moderators, and speakers, concludes these proceedings.
ASBMR would like to recognize the members of Organizing Committee, Sylvia Christakos, PhD, Marc K Drezner, MD, and Elizabeth Shane, MD, and the members of the Program Committee, Marie DeMay, MD, Robert Heaney, MD, Bruce Hollis, PhD, and Craig Langman, MD. Their dedication and hard work made this meeting, Contemporary Diagnosis and Treatment of Vitamin D–Related Disorders, a scientific success. ASBMR also extends its appreciation to the NIH Institutes that provided financial support for this meeting: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), National Institute on Aging (NIA), and Office of Dietary Supplements (ODS); to the scientists who spoke at the meeting; to the moderators; and to those who submitted their work.