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Bilirubin - One of the main components of bile, is produced mainly from hemoglobin of erythrocytes. Another source of bilirubin is myoglobin, cytochromes and heme pigments. When hemoglobin is broken down, free (indirect) bilirubin is initially produced. Free bilirubin travels from the spleen to the liver along with albumin. In the liver, it binds to glucuronic acid - it conjugates. The result is conjugated (direct) bilirubin, which is actively secreted into the bile ducts. Depending on which type of bilirubin concentration increases in plasma, hyperbilirubinemia is classified as both unconjugated and conjugated.
Increased direct bilirubin concentration:
Direct (conjugated) bilirubin - Combination of free bilirubin with glucuronic acid, makes up 25% of total bilirubin. It is a less toxic, water-soluble fraction that forms in the liver. Elevated levels of direct bilirubin in blood serum are associated with decreased excretion of conjugated pigment from the liver and bile ducts and manifest as cholestatic or hepatocellular jaundice. Abnormal increase in direct bilirubin levels leads to the appearance of this pigment in the urine. Since indirect bilirubin is not excreted in the urine, the presence of bilirubin in the urine emphasizes an increase in serum conjugated bilirubin levels.
Preferably for the test on empty stomach Presence.
It is recommended to limit alcohol intake, smoking and strenuous physical activity for at least 12 hours before the test.
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