<prompt> Gilbert syndrome- True is:Reduced activity of glucuronyl transferaseCauses indirect hyperbilirubinemiaNot required any treatmentAll of above  <response>: Ans. is D i.e., All of above Ref- o Bilirubin is the metabolic end product of heme. o Before excretion into bile, it is 1st glucuronidated by the enzyme bilirubin-uridine diphospho glucuronate glucuronosyltransferase UDPGT. o UDPGT activity is deficient or altered in three genetically and functionally distinct disorders Crigler-Najjar syndromes type I and II and Gilbert syndrome, producing congenital nonobstructive, nonhemolytic, unconjugated hyperbilirubinemia. o UGT1A1 is the primary UDPGT isoform needed for bilirubin glucuronidation, and complete absence of UGT1A1 activity causes CN type I. o CN type II is due to decreased UGTIA1 activity; o Gilbert syndrome also decreases normal enzyme activity but only to 30. o Unlike the Crigler-Najjar syndromes, Gilbert syndrome is benign and no treatment is required. 