Kadar serum microtubule-associated protein 1a/1b-light chain 3b yang rendah dan kadar serum F2-isoprostane yang tinggi sebagai faktor risiko preeklamsia

Background: Pre-eclampsia is a serious pregnancy complication with an incompletely understood pathogenesis. Autophagy dysfunction and oxidative stress, characterized by decreased microtubule-associated protein 1a/1b-light chain 3b (LC3B) and increased F2-isoprostane (F2-IsoPs), are thought to play a role in the development of pre-eclampsia. This study aimed to evaluate serum LC3B and F2-IsoPs levels as risk factors for pre-eclampsia. Methods: This observational analytical case-control study recruited 54 subjects (27 cases and 27 controls) consecutively at RSUP Prof. I G.N.G. Ngoerah from June to September 2023. Receiver Operating Characteristic (ROC) analysis was performed to determine the optimal cut-off values, and data were analyzed using SPSS v25 with a significance level of p<0.05. Results: Most subjects were under 30 years old, multiparous, and had a gestational age of 20–34 weeks in both groups. Bivariate analysis showed that serum LC3B levels were significantly lower in cases (233.99±111.41 ng/mL) compared to controls (354.20±140.28 ng/mL; p=0.001), while serum F2-IsoPs levels were significantly higher in cases (543.68 ± 112.20 pg/mL) than in controls (429.04±101.79 pg/mL; p<0.001). ROC analysis yielded a cut-off value of 266.440 ng/mL for LC3B (sensitivity 85.2%, specificity 70.4%, AUC 0.756; p=0.001) and 466.940 pg/mL for F2-IsoPs (sensitivity 81.5%, specificity 81.5%, AUC 0.810; p<0.001). Based on these cut-offs, low LC3B (<266.440 ng/mL) was found in 70.4% of cases versus 14.8% of controls (OR 13.66; 95% CI: 3.56–52.43; p<0.001), and high F2-IsoPs (≥466.940 pg/mL) were observed in 81.5% of cases versus 18.5% of controls (OR 19.36; 95% CI: 4.90–76.44; p<0.001). Conclusion: Low serum LC3B and high serum F2-IsoPs levels are significant risk factors for pre-eclampsia. Latar Belakang: Preeklamsia merupakan komplikasi kehamilan serius dengan patogenesis yang belum sepenuhnya dipahami. Disfungsi autophagy dan stres oksidatif, yang ditandai oleh penurunan microtubule-associated protein 1a/1b-light chain 3b (LC3B) dan peningkatan F2-isoprostane (F2-IsoPs), diduga berperan dalam terjadinya preeklamsia. Penelitian ini bertujuan mengevaluasi kadar serum LC3B dan F2-IsoPs sebagai faktor risiko preeklamsia. Metode: Penelitian ini menggunakan desain observasional analitik dengan pendekatan kasus-kontrol. Sebanyak 54 subjek (27 kasus dan 27 kontrol) direkrut secara consecutive sampling di RSUP Prof. I G.N.G. Ngoerah dari Juni hingga September 2023. Analisis Receiver Operating Characteristic (ROC) dilakukan untuk menentukan nilai cut-off optimal, dan data dianalisis menggunakan SPSS v25 dengan tingkat signifikansi p < 0,05. Hasil: Mayoritas subjek berusia <30 tahun, multipara, dan memiliki usia kehamilan 20–34 minggu pada kedua kelompok. Analisis bivariat menunjukkan bahwa kadar serum LC3B lebih rendah pada kasus (233,99 ± 111,41 ng/mL) dibanding kontrol (354,20 ± 140,28 ng/mL; p = 0,001), sedangkan kadar F2-IsoPs lebih tinggi pada kasus (543,68 ± 112,20 pg/mL) dibanding kontrol (429,04 ± 101,79 pg/mL; p < 0,001). Analisis ROC menghasilkan nilai cut-off 266,440 ng/mL untuk LC3B (sensitivitas 85,2%, spesifisitas 70,4%, AUC 0,756; p = 0,001) dan 466,940 pg/mL untuk F2-IsoPs (sensitivitas 81,5%, spesifisitas 81,5%, AUC 0,810; p < 0,001). Berdasarkan nilai cut-off tersebut, LC3B rendah (<266,440 ng/mL) ditemukan pada 70,4% kasus versus 14,8% kontrol (OR 13,66; 95% CI: 3,56–52,43; p < 0,001), dan F2-isoprostane tinggi (≥466,940 pg/mL) pada 81,5% kasus versus 18,5% kontrol (OR 19,36; 95% CI: 4,90–76,44; p < 0,001). Kesimpulan: Kadar serum LC3B yang rendah dan F2-IsoPs yang tinggi merupakan faktor risiko signifikan preeklamsia.