Clinical Usefulness of Direct/Total Bilirubin Ratio
Laboratory Medicine Online
; : 127-134, 2018.
Article
in Ko
| WPRIM
| ID: wpr-717399
Responsible library:
WPRO
ABSTRACT
BACKGROUND: The direct/total (d/t) bilirubin ratio can be used to distinguish the causes of jaundice in many patients who have increased levels of direct and indirect bilirubin. However, the reference range of the d/t ratio has not been established, hindering its clinical usefulness. This study assessed the clinical usefulness of the d/t ratio. METHODS: Paired total bilirubin and direct bilirubin tests (N=4,357) of cholestasis, hemolytic anemia, and neonatal jaundice were evaluated. Regression analyses were performed between total bilirubin and direct bilirubin, and between total bilirubin and the d/t ratio for each disease. Theoretical correlation models were established and used to compare the regression analyses data. RESULTS: The theoretical model and regression equation between total bilirubin and direct bilirubin displayed linear correlations for all three cholestatic diseases. The model and regression equation between total bilirubin and the d/t ratio showed reciprocal curve correlations for the cholestatic diseases. When the total bilirubin concentration exceeded approximately 10 mg/dL, the rate of change of the d/t ratio decreased and converged to a constant value between 0.7 and 0.9. CONCLUSIONS: If the total bilirubin concentration exceeds 10 mg/dL, cholestatic diseases can be diagnosed if the d/t ratio is more than 0.7. However, if the total bilirubin concentration is lower than 10 mg/dL, cholestatic diseases should be considered even if the d/t ratio is lower than 0.7. Therefore, use of the d/t ratio with total bilirubin could prove to be valuable in clinical settings.
Key words
Full text:
1
Database:
WPRIM
Main subject:
Reference Values
/
Bilirubin
/
Cholestasis
/
Hyperbilirubinemia
/
Anemia, Hemolytic
/
Jaundice
/
Jaundice, Neonatal
/
Models, Theoretical
Limits:
Humans
/
Newborn
Language:
Ko
Journal:
Laboratory Medicine Online
Year:
2018
Document type:
Article