High direct bilirubin does not usually affect cirrhosis measurement. Cirrhosis is a diffuse proliferation of fibrous tissue in the liver based on extensive necrosis of liver cells caused by fatty liver, alcoholic liver and other diseases, forming nodules, pseudo lobules, etc., which destroys the normal structure and function of the liver. Patients may show symptoms such as fatigue, loss of appetite, abdominal distension and jaundice. Cirrhosis is mainly diagnosed by laboratory tests of liver function and imaging tests. Liver function tests in patients with cirrhosis will reveal elevated indicators representing liver fibrosis such as type III procollagen peptide, prolyl hydroxylase, monoamine oxidase, laminin, etc. At the same time, there may be abnormalities in serum albumin, bilirubin, aminotransferases, etc., which represent the function of the liver. Imaging tests (ultrasound, CT, etc.) will reveal that the patient’s liver is enlarged, with thickened peritoneum, less smooth surface, and enhanced ultrasound echogenicity. Liver tissue biopsy may also be performed if necessary, and the diagnosis of cirrhosis can be confirmed if pseudolobules are found on pathologic examination. Cirrhosis affects the metabolism of bilirubin by liver cells, causing elevation of serum direct bilirubin, but elevation of direct bilirubin does not affect the measurement and diagnosis of cirrhosis. Patients with cirrhosis are advised to seek timely medical attention and actively receive treatment to avoid delaying their condition.