John Verano’s 1997 synthesis of Andean paleopathology guided two decades of research and was instrumental in establishing modern Andean paleopathology. This paper reviews the current state and new directions in the study of skeletal metabolic disorders in the Central Andean archaeological record. Key historical, ecological, methodological, and contextual issues intersect with the study of metabolic bone diseases in Andean paleopathology. This paper further examines known temporal and spatial distribution of these disorders, as well as the strengths and weaknesses of the record of linear enamel hypoplasias, cribra orbitalia, porotic hyperostosis, scurvy, and rickets. Many other metabolic bone diseases have yet to be documented such as pellagra, hypophosphatasia, osteomalacia, and mucopolysaccharidosis among others. This work closes with considerations in the search for these undocumented diseases, but such an effort is only one part of new wave of advancements just on the horizon. The study of metabolic diseases in Andean paleopathology can lead the development of more sophisticated approaches to data collection, analysis, and interpretation – especially regarding theoretical interpretations from various bodies of social theory to the Developmental Origins of Health and Disease hypothesis, life history approaches, and phenotypic adaptive plasticity and constraint.

约翰·维拉诺（John Verano）1997年对安第斯山脉古病理学的综合指导了二十年的研究，并在建立现代安第斯山脉古病理学中发挥了作用。本文综述了安第斯中部考古记录中骨骼代谢紊乱研究的现状和新方向。关键的历史，生态，方法论和背景问题与安第斯古病理学中代谢性骨疾病的研究相交。本文进一步研究了这些疾病的已知时空分布，以及线性釉质发育不全，斑马眼眶，多孔性骨质增生，坏血病和病的记录的优缺点。许多其他代谢性骨疾病，例如糙皮病，低磷血症，骨软化症和粘多糖贮积症等，尚未有文献记载。这项工作在寻找这些无证疾病的过程中考虑了所有因素，但是这种努力只是即将到来的新一波发展的一部分。在安第斯古病理学中对代谢性疾病的研究可以引领更复杂的数据收集，分析和解释方法的开发，尤其是从社会理论的各个方面到健康和疾病的发展起源假设，生活史方法以及表型适应性和约束性。