الفهرس 
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Abstract
Metabolic bone disease (MBD) of prematurity, also called osteopenia of prematurity is a condition characterized by reduction in bone mineral content (osteopenia) in low birth weight (LBW) infants less than 1500 g. birth weight and less than 34 weeks of gestational age due to lack of fetal mineralization during the last trimester.
The incidence of this problem in preterm infants has been declining due to improvement in nutritional management . However, MBD remains a significant problem among extremely preterm and very low birth weight (VLBW) infants.
The diagnosis of MBD of prematurity remains dependent on clinical suspicion and on biochemical markers especially serum alkaline phosphatase activity (APA) with a radiograph verifying the findings.
Wrist/knee x-ray was done to detect osteopenia in 60 preterm infants ≤34 weeks gestational age and <1500 g. birth weight from which 8 infants (13.3%) shown radiographic evidence of osteopenia where 52 infants (86.7%) were non-osteopenic and both birth weight and gestational age were significantly inversely related to both serum alkaline phosphatase level and radiographic evidence of osteopenia.
Serial measurements of serum alkaline phosphatase levels on at least two weeks revealed significantly higher values in osteopenic infants with no constant value at which the evidence of osteopenia occur but the optimal cut-off point with alkaline phosphatase level of 500 IU/L revealed 100 % sensitivity and 80.77% specificity, so the reliability of alkaline phosphatase levels as the only factor to predict the status of bone mineralization and to perform radiographic evaluation for osteopenia are still conflicting and birth weight <1000 grams or gestational age <32 weeks are more sensitive indicators of osteopenia.