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Elevation in unconjugated bilirubin indicates prehepatic or hepatic jaundice and may be managed medically;[12] whereas an increase in conjugated bilirubin suggests hepatocellular injury or cholestasis, which may necessitate bile duct surgery or therapeutic endoscopy.
Normal results can vary, but high bilirubin levels may mean your liver isn't working right. However, abnormal results don't always mean you have a medical condition that needs treatment. Other things may cause higher than normal bilirubin levels, such as certain medicines and foods or strenuous exercise.
Elevated levels may indicate liver damage or disease. Higher than normal levels of direct bilirubin in your blood may indicate your liver isn't clearing bilirubin properly.
Conjugation prevents bilirubin from passively being reabsorbed by the intestinal mucosa due to its hydrophilicity and large molecular size. Thus, conjugation works to promote the elimination of potentially toxic metabolic waste products.
In the liver, the unconjugated bilirubin is bound to glucuronide by the enzyme uridine 5'-diphospho-glucuronosyltransferase (UDP) and becomes conjugated bilirubin. Conjugated bilirubin is then excreted in bile.
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More critically, we found serum bilirubin levels were influenced by glucose metabolic status: pre-diabetes and new-onset diabetes had higher bilirubin levels than individuals with normal fasting glucose, while the bilirubin levels decreased with the prolonged duration of diabetes (Fig. 1).
In diabetes, the protective properties of bilirubin are likely due to its potent antioxidant properties (Fig. 1). Bilirubin inhibits lipid peroxidation and attenuates LDL oxidation (17). Chronic hyperglycemia results in the generation of reactive oxygen species (e.g., superoxide), predominantly by the mitochondria.
Experimental and human studies show that elevated bilirubin levels are associated with decreased risk of type 2 diabetes (T2D) and diabetes-related outcomes (1\u20136).
Depending on the severity of deficiency, vitamin K may be supplemented orally or intramuscularly. Ursodiol can be used to stimulate bile flow in children with cholestasis. Nonabsorbable ion exchange resins ( and ) may be used in patients with PFIC to treat diarrhea.
High levels of bilirubin could mean your liver is not functioning correctly. However, high levels can also be due to medications, exercise, or certain foods. Bilirubin is also a product of breakdown of red blood cells, and an elevated reading may be related to disorders of red blood cells and not liver disease.

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