At first, bilirubin is unconjugated, meaning it does not bind to chemicals in the body. It is not water soluble in this state due to the bond with albumin that enables it to travel through the body to the liver. In the liver, an enzyme called glucuronyltransferase changes the bilirubin into a conjugated (binding) state by removing the albumin, and the bilirubin becomes a component of bile. Bilirubin must be conjugated to be expelled from the body.
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