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Bilirubin as a Biomarker in Liver Disease

  • Nahum Méndez-SánchezEmail author
  • Libor VítekEmail author
  • Nancy E. Aguilar-OlivosEmail author
  • Misael UribeEmail author
Reference work entry
Part of the Biomarkers in Disease: Methods, Discoveries and Applications book series (BDMDA)

Abstract

Bilirubin had been studied since the eighteenth century because assessment of serum bilirubin concentration is important in the diagnosis and prognosis of patients with liver disorders. All prognostic scores for liver diseases include bilirubin in their calculations, and some studies have shown that bilirubin is an independent biomarker of mortality risk. We know that a high total bilirubin level is an indicator of disease, but nowadays there is evidence indicating the association of a low level with increased risk of diseases, for example, cancer or cardiovascular disorders. Bilirubin is a potential biomarker because its concentration is associated with mortality and may also be associated with the prevention of disease. This chapter will review the usefulness of bilirubin as a marker in liver diseases and their possible use to assess outcomes and risk of other non-liver diseases.

Keywords

Chronic liver diseases Acute liver failure Gilbert syndrome Cardiovascular diseases Cancer Autoimmune diseases Prognosis Mortality 

List of Abbreviations

ABIC

Age–bilirubin–INR–creatinine

ACLF

Acute-on-chronic liver failure

AH

Alcoholic hepatitis

ALF

Acute liver failure

ALFIHMS

ALF in-hospital mortality score

APACHE II score

Acute Physiology and Chronic Health Evaluation II score

BLVR

Biliverdin reductase

CB

Conjugated bilirubin

CO

Carbon monoxide

CTP score

Child–Turcotte–Pugh score

ECBL

Early change in bilirubin level

GAHS

Glasgow alcoholic hepatitis score

HCl

Hydrochloric acid

HELLP

Hemolysis, elevated liver enzyme levels, and low platelet count

HIV

Human immunodeficiency virus

HMOX

Heme oxygenase

HPLC

High-performance liquid chromatography

INR

International normalized ratio

KCH

King’s College Hospital

LT

Liver transplantation

mDF

Maddrey discriminant function

MELD

Model for End-Stage Liver Disease

NHANES

National Health and Nutrition Examination Survey

OATP

Organic anion-transporting protein

TcBm

Transcutaneous bilirubin measurement

UCB

Unconjugated bilirubin

UGT1A1

Bilirubin UDP-glucuronosyltransferase

Notes

Acknowledgements

This work was supported by the Medica Sur Clinic and Foundation (NMS) and by the following grants: PRVOUK 4102280002 from the Czech Ministry of Education and RVO VFN64165 from the Czech Ministry of Health (LV).

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© Springer Science+Business Media Dordrecht 2017

Authors and Affiliations

  1. 1.Liver Research UnitMedica Sur Clinic & FoundationMexico CityMexico
  2. 2.4th Department of Internal Medicine, and Institute of Medical Biochemistry and Laboratory Diagnostics, 1st Faculty of MedicineCharles University in PraguePragueCzech Republic

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