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  • Title: Relationship between transcutaneous bilirubin and circulating unbound bilirubin in jaundiced neonates.
    Author: Letamendia-Richard E, Ammar RB, Tridente A, De Luca D.
    Journal: Early Hum Dev; 2016 Dec; 103():235-239. PubMed ID: 27838549.
    Abstract:
    BACKGROUND: Transcutaneous bilirubin (TcB) consists of the skin-deposited bilirubin. Free bilirubin represents the protein-unbound bilirubin (UB) that is able to pass into the tissues. We aimed to describe the relationship UB-TcB and study the passage of UB into the skin. METHODS: We prospectively enrolled 194 neonates and we measured TcB, UB, serum bilirubin and albumin. Multiple sites TcB measurement was performed, bilirubin-albumin equilibrium constant and plasma bilirubin avidity (PBA) were calculated. RESULT: TcB has a similar correlation with UB and TSB. There is a quadratic relationship between UB and TcB (R2=0.48; p<0.001), remaining significant (β for UB2=-0.8; p<0.001. β for UB=1.1; p<0.001) after adjustment for gestational age, birth weight, postnatal age and albumin (Adj-R2=0.72). UB contributes to the skin bilirubin deposition, as there are significant correlations between albumin and TcB (r=-0.202; p=0.01) and between PBA and ΔTcB (r=0.323; p=0.017). CONCLUSION: TcB assay does not seem to directly replace UB measurement. However, TcB and UB are linked by a quadratic relationship: UB contributes to the skin bilirubin deposition but it is not the only bilirubin species measured by transcutaneous bilirubinometry.
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