karya tulis akhir pengaruh ekstrak daun ginseng...
TRANSCRIPT
KARYA TULIS AKHIR
PENGARUH EKSTRAK DAUN GINSENG JAWA (Talinum triangulare)
TERHADAP HISTOPATOLOGI HEPAR TIKUS JANTAN (Rattus
norvegicus strain wistar) YANG DIBERI DIET KOLESTEROL TINGGI
Oleh:
TRI NURDIANI
201310330311150
FAKULTAS KEDOKTERAN
UNIVERSITAS MUHAMMADIYAH MALANG
2017
HASIL PENELITIAN
PENGARUH EKSTRAK DAUN GINSENG JAWA (Talinum triangulare)
TERHADAP HISTOPATOLOGI HEPAR TIKUS PUTIH JANTAN (Rattus
norvegicus strain wistar) YANG DIBERI DIET KOLESTEROL TINGGI
KARYA TULIS AKHIR
Diajukan kepada
Universitas Muhammadiyah Malang
untuk Memenuhi Salah Satu Persyaratan
dalam Menyelesaikan Program Sarjana
Fakultas Kedokteran
Oleh:
TRI NURDIANI
201310330311150
UNIVERSITAS MUHAMMADIYAH MALANG
FAKULTAS KEDOKTERAN
2017
LEMBAR PENGESAHAN
LAPORAN HASIL PENELITIAN
Telah disetujui sebagai hasil penelitian untuk memenuhi persyaratan
Pendidikan Sarjana Fakultas Kedokteran Universitas Muhammadiyah Malang
Tanggal : Januari 2017
Pembimbing I
dr. Desy Andari, M.Biomed
Pembimbing II
dr. Thontowi Djauhari NS., M.Kes
Mengetahui, Dekan Fakultas Kedokteran
Universitas Muhammadiyah Malang
dr. Irma Suswati, M.Kes
KATA PENGANTAR
Alhamdulillah, dengan memanjatkan puji dan syukur kehadirat Tuhan Yang Maha
Esa serta dengan berkat dan rahmat-Nya sehingga tugas akhir penulis dengan
Judul “Pengaruh Ekstrak Daun Ginseng Jawa (Talinum Triangulare) Terhadap
Histopatologi Hepar Tikus Putih Jantan (Rattus Norvegicus Strain Wistar) Yang
Diberi Diet Kolesterol Tinggi” dapat terselesaikan dengan baik. Begitu pula
Dialah yang menyelaraskan gerakan tangan dan pikiran dalam merangkai huruf
menjadi kata dan selanjutnya menjadi kalimat dalam penulisan tugas akhir ini.
Segala sesuatu yang benar dalam tugas akhir ini datang dari Allah SWT, dan
segala kekeliruan dalam penulisan ini datangnya dari diri penulis sendiri.
Dalam penyelesaian tugas akhir ini penulis banyak mengalami kesulitan,
tetapi berkat dukungan, bimbingan, dan bantuan dari dosen pembimbing dalam
rangka penyusunan dan dorongan dari berbagai pihak akhirnya penulis dapat
menyelesaikan tugas akhir ini tepat pada waktunya.
Penulis menyadari bahwa penelitian ini masih belum sempurna, sehingga
masih membutuhkan saran dari berbagai pihak. Penulis berharap skripsi ini dapat
menjadi wujud ibadah penulis kepada Zat Yang Maha Mengetahui lagi Bijaksana,
dan dapat memberikan manfaat bagi para pembaca.
Malang, Januari 2017
Penulis
UCAPAN TERIMA KASIH
1. Ibunda Hariyati dan Ayahanda Nurdin Lasupu selaku orangtua penulis
yang telah memberikan dorongan dan motivasi serta kasih sayang,
sehingga penulis bisa menyelesaikan karya tulis ini.
2. dr. Desy Andari, M.Biomed selaku pembimbing I atas segala dukungan,
masukan dan saran yang sangat luar biasa dalam penyusunan karya tulis
ini.
3. dr. Thontowi Djauhari NS., M.Kes selaku pembimbing II atas segala
bimbingan dan koreksi serta motivasi yang diberikan demi kesempurnaan
karya tulis ini
4. dr. Gita Sekar Prihanti, M.Pd. Ked selaku dosen penguji yang telah
meluangkan waktu untuk menguji dan memberikan banyak masukan untuk
menyelesaikan tugas akhir ini.
5. dr. Irma Suswati selaku dekan Fakultas kedokteran Universitas
Muhammadiyah Malang.
6. Seluruh staf tata usaha Fakultas kedokteran Universitas Muhammadiyah
Malang atas segala dukungan yang telah diberikan.
7. Sahabat penulis, Muhammad Aril Putra, Diandra, Bunga, Nabila, Firda,
Febby, Chika, Ganda, dan Gagas yang telah banyak membantu dan
memberikan motivasi serta doanya dalam penyusunan laporan penelitian
ini.
8. Sejawat kelompok penelitian Rika, Daus, Tiara, Hendrian, dan Ricky yang
telah banyak membantu dalam masa penelitian dan memberi motivasi
dalam penyusunan laporan ini
9. Segenap keluarga besar Asisten Dosen Patologi Klinik Fakultas
Kedokteran Universitas Muhammadiyah Malang, dr. Sulistyo Mulyo
Agustini, Sp. PK, dr. Diah Hermayanti, Sp. PK, Mas Nyono, Bu Pat,
Ajeng, Baiq, Memey, Apri, kakak-kakak dan adik-adik, yang telah
memberikan kesempatan untuk belajar bersama dan berbagi ilmu.
10. Seluruh teman-teman angkatan 2013 yang tidak bisa disebutkan satu
persatu. Terimakasih atas segala bantuan, motivasi, doa selama
perkuliahan. Semoga kita semua menjadi dokter yang bermaanfaat bagi
agama, bangsa, dan negara. Aamiin.
11. Semua pihak yang tidak dapat disebutkan namanya satu persatu, yang
telah memeberikan dukungan dan motivasi dalam penyeleseaian laporan
penelitian ini.
DAFTAR ISI HALAMAN JUDUL .................................................................................. i LEMBAR PENGESAHAN ....................................................................... ii LEMBAR PENGUJIAN .......................................................................... iii PERNYATAAN ORISINALITAS .......................................................... iv KATA PENGANTAR .............................................................................. v ABSTRAK .............................................................................................. viii ABSTRACT............................................................................................... ix DAFTAR ISI ............................................................................................. x DAFTAR TABEL .................................................................................. xiii DAFTAR GAMBAR .............................................................................. xiv DAFTAR SINGKATAN ......................................................................... xv DAFTAR LAMPIRAN .......................................................................... xvi BAB I PENDAHULUAN .......................................................................... 1
1.1 Latar Belakang .............................................................................. 1 1.2 Rumusan Masalah ......................................................................... 3 1.3 Tujuan Penelitian .......................................................................... 3
1.3.1 Tujuan Umum ...................................................................... 3 1.3.2 Tujuan Khusus...................................................................... 4
1.4 Manfaat Penelitian ........................................................................ 4 1.4.1 Manfaat Akademis ................................................................ 4 1.4.2 Manfaat Klinis ..................................................................... 4 1.4.3 Manfaat Masyarakat ............................................................. 4
BAB II TINJAUAN PUSTAKA ............................................................... 5 2.1 Daun Ginseng Jawa ....................................................................... 5
2.1.1 Taksonomi Ginseng Jawa ..................................................... 5 2.1.2 Morfologi Daun Ginseng Jawa ............................................. 5 2.1.3 Habitat dan Distribusi Tanaman Ginseng Jawa ..................... 6 2.1.4 Penggunaan Daun Ginseng Jawa .......................................... 6 2.1.5 Kandungan Daun Ginseng Jawa............................................ 7
2.2 Hepar Manusia .............................................................................. 7 2.2.1 Anatomi................................................................................ 7 2.2.2 Histologi ............................................................................... 9 2.2.3 Fisiologi ............................................................................. 10
2.3 Tikus(Rattus norvegicus) ............................................................. 11 2.3.1 Hepar Tikus ........................................................................ 12
2.3.1.1 Anatomi dan fisiologi .................................................. 12 2.3.1.2 Histologi ..................................................................... 14
2.4 Metabolisme Lemak .................................................................... 16 2.5 Perlemakan Hati Non Alkoholik .................................................. 18
2.5.1 Definisi............................................................................... 18 2.5.2 Patogenesis ......................................................................... 19 2.5.3 Faktor Resiko ..................................................................... 20 2.5.4 Tanda dan Gejala ................................................................ 21 2.5.5 Gambaran Histopatologis.................................................... 22
2.6 Dislipidemia ................................................................................ 25 2.6.1 Definisi............................................................................... 25
2.6.2 Komposisi Lipoprotein ....................................................... 26 2.6.3 Klasifikasi Kadar Lipid Plasma ........................................... 26 2.6.4 Dislipidemia dan Pengaruhnya pada NAFLD...................... 27
2.7 Radikal Bebas ............................................................................. 27 2.8 Stes Oksidatif .............................................................................. 28
2.8.1 Peroksidasi Lipid ................................................................ 28 2.8.2 Kerusakan Protein .............................................................. 28 2.8.3 Kerusakan DNA ................................................................. 29
2.9 Antioksidan .................................................................................. 29 2.9.1 Mekanisme Kerja Antioksidan ............................................ 30 2.9.1.1 Peran Antioksidan Enzimatik ........................................... 30 2.9.1.2 Peran Antioksidan Non Enzimatik ................................... 31
BAB III KERANGKA KONSEP DAN HIPOTESIS............................. 35 3.1 Kerangka Konsep ........................................................................ 35 3.2 Hipotesis ..................................................................................... 37
BAB IV METODE PENELITIAN ......................................................... 38 4.1 Rancangan Penelitian .................................................................. 38 4.2 Tempat dan Waktu Penelitian ...................................................... 38 4.3 Populasi dan Sampel ................................................................... 38
4.3.1 Populasi .............................................................................. 38 4.3.2 Sampel ............................................................................... 38 4.3.3 Besar Replikasi ................................................................... 38 4.3.4 Teknik Pengambilan Sampel............................................... 40 4.3.4 Karakteristik Sampel Penelitian .......................................... 40
4.4 Variabel dan Definisi Operasional ............................................... 40 4.4.1 Variabel .............................................................................. 40 4.4.2 Definisi Operasional ........................................................... 41
4.5 Bahan dan Instrumen ................................................................... 42 4.5.1 Bahan ................................................................................. 42 4.5.2 Instrumen ........................................................................... 42
4.6 Alur Penelitian ............................................................................ 44 4.7 Prosedur Penelitian ...................................................................... 45
4.7.1 Pembagian Kelompok Tikus ............................................... 45 4.7.2 Adaptasi ............................................................................. 46 4.7.3 Penentuan Dosis Ekstrak Daun Ginseng Jawa ..................... 46 4.7.4 Pemberian Diet Kolesterol Tinggi ....................................... 47 4.7.5 Pembuatan Ekstrak Daun Ginseng Jawa ............................. 48 4.7.6 Proses Anestesi dan Pembedahan Hewan Coba .................. 49 4.7.7 Perlakuan Terhadap Hewan Coba Setelah Dibedah ............. 49 4.7.8 Pembuatan Sediaan Histologi ............................................. 49 4.7.9 Pengamatan Hasil ............................................................... 51 4.7.9 Analisis Data ...................................................................... 51
BAB V HASIL PENELITIAN DAN ANALISIS DATA ....................... 53 5.1 Hasil Penelitian .......................................................................... 53 5.2 Analisis Data.............................................................................. 55 BAB VI PEMBAHASAN ........................................................................ 57
BAB VII KESIMPULAN DAN SARAN ................................................ 61 7.1 Kesimpulan ................................................................................ 61 7.2 Saran .......................................................................................... 61 LAMPIRAN ............................................................................................ 62 DAFTAR PUSTAKA .............................................................................. 76
DAFTAR LAMPIRAN
LAMPIRAN HALAMAN
Lampiran 1 Hasil Pengamatan.............................................................................62
Lampiran 2 Analisis Data....................................................................................63
Lampiran 3 Dokumentasi.....................................................................................69
Lampiran 4 Surat Keterangan Kelayakan Etik....................................................70
Lampiran 5 Surat Determinasi Tanaman Ginseng Jawa......................................71
Lampiran 6 Surat Keterangan Penelitian.............................................................72
Lampiran 7 Surat Keterangan Pembacaan Histopa.............................................73
Lampiran 8 kartu konsultasi.................................................................................74
DAFTAR PUSTAKA Abdel-Misih, Bloomston, 2010, Liver Anatomy , Elsevier, pp.1-17 Munaf S, 2008, Obat-Obat Penurun Lipid Darah, dalam: Kumpulan Kuliah
Farmakologi Edisi 2, EGC, Jakarta, pp.408-409 Afolabi OB, Oloyede OI, 2014 , Antioxidant Properties of the Extracts of Talinum
Triangulare and its Effect on Antioxidant enzymes in Tissue Homogenate of Swiss Albino Rat, Toxicology International, vol.21, no.3, Sep, pp. 307–313.
Ahmed M, 2015, Non-alcoholic fatty liver disease in 2015, World Journal of
Hepatology, vol.7, no.11, Jun, pp. 1450-1459 Aja PM, Okaka ANC, Onu PNC, Ibiam U, Urako AJ, 2010, Phytochemical
Composition of Talinum triangulare (Water Leaf) Leaves , Pakistan Journal of Nutrition vol.9, no.6, pp. 527-530
Alexandru I, 2011, Experimental use of animals in research spa, Balneo Research
Journal, vol. 2, no. 1 Amarapurkar D, Amarapurkar DN , Hashimoto E, Lesmana LA, Sollano JD, Chen
PJ, Goh KL, 2007, How common is non-alcoholic fatty liver disease in the Asia-Pacific region and are there local differences?, Journal of Gastroenterology and Hepatology, vol. 22, no. 6, pp. 788–793.
Ameh GI, Eze CS, 2010, Phytochemical And Ethnobotanical Evaluation Of The
Leaves Of Talinum triangulare (Jacq) Wild., Nigerian Journal of biotechnology, Vol.21, pp.50-54
Andarwulan N, Batari R, Sandrasari DA, Bolling B, Wijaya H, 2010, Flavonoid
Content and Antioxidant Activity of Vegetables from Indonesia, Journal of Food Chemistry, vol.1, no.33, pp. 1231-1235.
Angulo P. 2002. Nonalcoholic Fatty Liver Disease, The New England Journal of
Medicine, vol. 346, pp. 1221-1231. Arauna Y, Aulanni’am, dan Oktavianie DA, 2008, ‘Studi Kadar Trigliserida Dan
Gambaran Histopatologi Hepar Hewan Model Tikus (Rattus norvegicus) hiperkolesterolemia Yang Diterapi Dengan Ekstrak Air Benalu Mangga (Dendrophthoe petandra). Universitas Brawijaya Malang.
Arts JWM, Kramer K, Arndt SS, Ohl F, 2012, The Impact Of Transportation On
Physiological and Behavioral Parameter In Wistar Rats : Implication For Aclimatization Periods,The ILAR Journal, Laboratory Animal Science Utrecth University, pp.1-17
Asha B , Madhav S, Upadhyaya K, 2012, An Huge Updated Review On Dyslipidemia Etiology With Various Approaches For Its Treatment’, Pharmacophore, Vol. 3, no.5, pp. 244-264
Baratta JL, Ngo A, Lopez B, Kasabwalla N, Longmuir KJ, Robertson RT, 2009,
Cellular Organization of Normal Mouse Liver: A Histological, Quantitative Immunocytochemical, and Fine Structural Analysis, Histochem Cell Biol. Vol. 131, no.6, pp. 713–726.
Birben E, Sahiner UM, Sackesen C, Erzurum S, Kalayci O, 2012, Oxidative Stress
and Antioxidant Defense, World Allergy Organization, Jan, vol.5, pp.9-19 Bouwens L, Baekeland M, De Zanger R, Wisse E, 1986, Quantitation, tissue
distribution and proliferation kinetics of Kupffer cells in normal liver’,
Hepatology, vol.6, pp. 718–722. Browning JD, Browning JD, Szczepaniak LS, Dobbins R, Nuremberg P, Horton
JD, Cohen JC, Grundy SM, Hobbs HH, 2004, Prevalence of hepatic steatosis in an urban population in the United States: impact of ethnicity, Journal of Gastroenterology and Hepatology, pp.1387-1395.
Geller DA, Goss JA, Tsung A, 2010, Liver, dalam: Schwartz’s principles of
Surgery 9th edition’, McGraw-Hill Publishing, New York. Brunt EM, Tiniakos DG, 2009, Alcoholic and non-alcoholic fatty liver disease,
dalam: Pathology of the GI tract, liver, biliary tract and pancreas. Saunders, Philadelphia, pp.1087-1114
Chatrath H, Vuppalanchi R, Chalasani N, 2013, Dyslipidemia in Patients with
Nonalcoholic Fatty Liver Disease , Semin Liver Dis, vol.32, no.1, Feb., pp. 22–29
Department of Agriculture Regional Field, 2014,Talinum Triangulare (Jacq.)
Willd [online] , dari: http://cagayandeoro.da.gov.ph/wp-content/uploads/2013/04/TALINUM.pdf [23 Januari 2016]
Ekpo IA, Osuagwu AN, Okpako EC, Agbor RB, Ekanem BE, 2012,
Physicochemical and Morphological Features of Talinum triangulare (water-leaf) Exposed to Hydrocarbon Polluted Soil, World Journal of Environmental Biosciences, vol.2, no.1, pp.1-6
Eroschenko VP, 2010, Atlas Histologi Difiore: Dengan Korelasi Fungsional, Ed.
11. ed., EGC, Jakarta. El-Kader SMA, Ashmawy EM, 2015, Non-alcoholic fatty liver disease: The
diagnosis and management, World Journal of Hepatology, vol.7, no.6, Apr., pp.846-858
Ezekwe MO, Besong SA, Igbokwe PE, Ezekwe EI , 2002, Beneficial influence of Purslane and Waterleaf supplementation on cardiovascular disease risk in humans, Journal of Federation of American Societies for Experimental Biology, vol.16, no.4, pp. A639
Ezekwe CI, Okoro IJ, Ugwu OPC, dan Ezea SC, 2013, The Effect Of Methanol
Extract Of TalinumTriangulare On Some Selected Hematological And Kidney Parameters Of Experimental Rats, World Journal Of Pharmacy And
Pharmaceutical Sciences, Vol. 2, no. 6, pp. 4383-4396.
Ezekwe CI, Chidinma RC, dan Okechukwu PC, 2013, ’The Effect of Methanol
Extract of Talinum Triangulare (Water Leaf) on the Hematology and Some Liver Parameters of Experimental Rats’, Global Journal of Biotechnology & Biochemistry no.8 vol.2, hal.51-60
Fahy E, Cotter D, Sud M, Subramaniam S, 2011, Lipid classification, structures
and tools, Biochim Biophys Acta, vol.1811,no.11, Nov., pp. 637–647. Fan JG, Saibara T, Chitturi S, Kim BI, Sung JJ, Chutaputti A, 2007, What are the
risk factors and settings for non-alcoholic fatty liver disease in Asia-Pacific?, Journal of Gastroenterol and Hepatology, vol.22, no.6, pp. 794–800
Fasuyi AO, 2007, Bio-nutritional evaluations of three tropical leaf vegetables
(Telfairia occidentalis, Amaranthus cruentus and Talinum triangulare) as sole dietary protein sources in rat assay, Food Chem, vol.10, no.3
Fauzi F, 2011, Efek Ekstrak Metanol Rimpang Temu Giring (Curcuma
Hyeneana Val.) Terhadap Kadar Kolesterol Dan Gambaran Histopatologi Hepar Tikus (Rattus Norvegicus) Yang Diberi Diet Kolesterol tinggi
Furth R, Cohn ZA, Hirsh JG, Humphrey JH, Spector WG, Langevoort HL, 1972,
The mononuclear phagocyte system: a new classification of macrophages, monocytes, and their precursors, Bull WHO. Vol.46, pp. 845-852.
Fontem DA, Schippers RR, 2004, Talinum triangulare (Jacq.), Plant Resources of
Tropical Africa, vol.1, no.3, pp.24 Gaggini M, Morelli M, Buzzigoli E, DeFronzo RA, Bugianesi E, Gastaldelli A.
2013, Non-Alcoholic Fatty Liver Disease (NAFLD) and Its Connection with Insulin Resistance, Dyslipidemia, Atherosclerosis and Coronary Heart Disease, Nutrients, vol.5, pp. 1544-1560
Gomberg, 2003, Health benefits of fruit and vegetables are from additive and
synergistic combinations of phytochemicals, Am J Clin Nutr, vol.78, no.3, pp. 517S
Gray, Lewis, 2000, Gray’s Anatomy of the Human Body. 20th Ed, Bartleby, New
York
Gulcin I, Huyut Z, Elmastas M, dan Aboul-Enein HY, 2010, Radical scavenging
and antioxidant activity of tannic acid, Arabian Journal of Chemistry ,vol. 3, pp. 43–53
Gutowski M, Kowalczyk S, 2013, A study of free radical chemistry: their role and pathophysiological significance, ACTABP, Vol. 60, No 1
Guyton AC, Hall JE, 2014,’Metabolisme Lipid’ dalam Buku Ajar Fisiologi
Kedokteran Edisi 12, ECG, Jakarta . Hasan I, 2009, Perlemakan hati non-alkoholik dalam Sudoyo, AW., Setiyohadi,
B., Alwi, I., Simadibrata, M., & Setiati, S. (eds). Buku Ajar Ilmu Penyakit Dalam. 5 edn. InternaPublishing. Jakarta: 695-701.
Hatma RD, 2011, Lipid Profiles Among Diverse Ethnic Groups in Indonesia,
University of Indonesia,vol.43, vol.1 Halliwell B, Gutteridge JMC, 2007, Free Radicals in Biology and Medicine, 4th
ed., Oxford, UK Oxford University Press. Hewitt KC, Rad JG, McGregor HC, Sapp H, Short MA, Fashir SA, Zeng
H, Alwayn IP, 2015, Accurate assessment of liver steatosis in animal models using a high throughput Raman fiber optic probe, Analyst.
Huy LAI, He H, Huy CP, 2008, Free Radicals, Antioxidants in Disease and Health’,International journal of Biomedical science, vol. 4 no. 2
INSA (Indian national science academy), 2000, Guideline For Care and Use Of
Animals In Scientific Research, Bengal Offset Works, New Delhi, pp. 14-15 Jin Xi, Xiang Zun, Chen Yi-Peng, Ma Kui-Fen, Ye Yue-Fang, Li You-Ming,
2013, Uncoupling protein and nonalcoholic fatty liver disease, Chinese Medical Journal
Juluri R, Vuppalanchi R, Olson J, Ünalp A,Van Natta M, Cummings OW,
Tonascia J, Chalasani N, 2011, Generalizability of the NASH CRN Histological Scoring System for Nonalcoholic Fatty Liver Disease, Journal of Clinical Gastroenterology, vol.45, no.1, Jan., pp. 55–58
Koolhaas JM, 2010, The UFAW Handbook on The Care and Management of Laboratory and Other Research Animals, The Laboratory Rat, 8th Edition, Wiley Blackwell, Groningen
Kumalaningsih S, 2006, Antioksidan Alami-Penangkal Radikal Bebas, Sumber,
Manfaat, Cara Penyediaan dan Pengolahan. Surabaya: Trubus Agrisarana. Kumar S, Pandey AK, 2013, Chemistry and Biological Activities of Flavonoids:
An Overview, The ScientificWorld Journal
Liao DY, Chai YC, Wang SH, Chen CW, Tsai M, 2015. Antioxidant Activities
and Content of Flavonoids and Phenolic Acids of Talinum triangulare Extracts and Their Immunomodulatory Effects, Journal of Food and Drug Analysis, vol. 23, pp. 294-302
Liang D, Zhou Q, Gong W, Wang Y, Nie Z, He H, Li J, Wu J, Wu C, dan Zhang J, 2011, ’Studies on the antioxidant and hepatoprotective activities of polysaccharide from Talinum triangulare’, Journal of Ethnopharmacology no.136, hal.316–321
Lobo V, Patil A, Phatak A, dan Chandra N, 2010, Free radicals, antioxidants and
functional foods: Impact on human health, Pharmoacognosy review Des, vol.4 , no. 8, pp.118–126
Magee N, Zou A, dan Zhang Y, 2016, ‘Pathogenesis of Nonalcoholic
Steatohepatitis: Interactions between Liver Parenchymal and Nonparenchymal Cells’, BioMed Research International
Martins PNA, Neuhaus P, 2006, Surgical anatomyof the liver, hepatic vasculature
and bile ducts in the rat, Liver International. Mensah JK, Okoli RI, Ohaju-Obodo JO, Eifediyi K, 2008, Phytochemical,
nutritional and medicinal properties of somevegetables consumed by Edo people of Nigeria, African Journal of Biotechnology’, vol.7, no.14, pp.3204-2309.
Netter, Frank H, 2014, Atlas of Human Anatomy 25th Ed’, EGC, Jakarta Notoadmodjo S, 2012, Metodologi Penelitian Kesehatan, Rineka Cipta, Jakarta Ogbonnaya EC, Chinedum E K, 2013,Vitamin and Carotenoid Composition of
Raw and Decoctions of Water Leaf (Talinum triangulare), Biochem Pharmacol, vol. 2, no.3,pp.1-3
Paderi AZ, 2007, Kajian Perubahan Jaringan Uji Khasiat Buah Merah (Pandanus
conoideus) sebagai Bahan Penghambat Kerusakan Hati. Fakultas Kedokteran Hewan, Institut Pertanian Bogor.
Paget G, Barnes J, 1964, Toxicity Tests, dalam : Laurence DR, Bacharach AL,
editors. Evaluation of Drug Activities Pharmacometrics, London, New York: Academic Press.
Paulsen F, Waschke J, 2013, Sobotta Atlas Anatomi Manusia : Anatomi Umum
dan Muskuloskeletal, EGC,Jakarta
Patekar D, Kheur S, Bagul N, Kulkarni M, Mahalle A, Ingle A, 2013, Antioxidant Defence System, Oral & Maxillofacial Pathology Journal [ OMPJ ], Vol. 4 No. 1
Pan M, Cederbaum AI, Zhang YL, 2004, Lipid peroxidation and oxidant stress
regulate hepatic apolipoprotein B degradation and VLDL production, J Clin Inves, vol.113, no.9,pp.1277–1287.
Prior RL, Wu X, Schaich K, 2005, Standardized methods for the determination of
antioxidant capacity and phenolics in foods and dietary supplements, J. Agric. Food Chem, vol.53, pp.4290–4303.
Purwanti S, 2012, Efek Antihiperlipidemia Ekstrak Etanol 70% buah Oyong
(Luffa acutangula (L.) Roxb) Pada Tikus Putih Jantan yang Diberi Diit Tinggi Kolesterol dan Lemak, Depok: Universitas Indonesia.
Racchi ML, 2013, Antioxidant Defenses in Plants with Attention to Prunus and
Citrus spp, Antioxidants, vol.2, pp. 340-369 Rahmawansa, 2009, Dislipidemia sebagai faktor risiko utama penyakit jantung
koroner, CDK, vol.36, no.3, pp.181-184 Reddy JK, 2006, Lipid Metabolism and Liver Inflamation, AJP Gastrointestinal
Liver Physiology, vol.290, pp.852-858 Rosensen, Robert S, 2009, Lipoprotein Classification; Metabolism; and Role in
Atherosclerosis, Up to Date Sänger C, Schenk A, Schwen LO, Wang L, Gremse F, Zafarnia S, 2015,
Intrahepatic Vascular Anatomy in Rats and Mice - Variations and Surgical Implications, Journal PLOS one, vol.10, no.11
Santas IGP, Pragojo B, 1999, Studi Taksonomi Talinum paniculatum (Jacq.)
Gaertn. dan Talinum triangulare (Jacq.) Willd, Warta Tanaman Obat Indonesia, vol.5, no.4
Sass DA, Chang P, Chopra KB., 2005, Non Alcoholic Fatty Liver Disease: A
Clinical Review, Digestive Diseases and Sciences, vol. 50, no.1, pp. 171-180. Sastroasmoro S, 2008, Pemilihan Subyek Penelitian. Dalam: Sastroasmoro, S.,
Ismael, S., ed. Dasar-Dasar Metodologi Penelitian Klinis. CV. Sagung Seto Jakarta.
Savannah, 2016,The Internet Pathology Laboratory for medical Education, the
University of Utah Eccles Health Sciences Library.
Saxena M, Saxena J, Pradhan A, 2012, Flavonoids And Phenolic Acids As Antioxidants In Plants And Human Health, International Journal Of Pharmaceutical Sciences Review And Research, Vol. 6, No.12, Pp. 130-134
Sen S, Chakraborty R, Sridhar C, Reddy Ysr, dan De B, 2010, Free Radicals,
Antioxidants, Diseases And Phytomedicines: Current Status And Future Prospec, International Journal Of Pharmaceutical Sciences Review And Research, Vol. 3, No. 1.
Sena LA, Chandel NS, 2012, Physiological Roles of Mitochondrial Reactive
Oxygen Species, Molecular Cell 48 SEPA (Scottish Environmental Protection Agency), 2009, Burial of Small
Quantities of Rodent Carcasses Poisoned on Farmland, National West Policy unit, pp.1-2
Sharp PE, La regina MC, 2010, The Laboratory Rat, Taylor & Francis. USA. ShindeS, Chivate N, Kulkarni P, 2013, Hypolipidemic Activity Of Psidium
Guajava Linn Leaves Extracts In Hyperlipidemic Rats, International Journal Of Pharmacy And Pharmaceutical Sciences, Vol. 5, No. 1
Smith A, Adanlawo Ig, 2014, In Vitro And In Vivo Antioxidant Activity Of
SaponinExtracted From The Root Of Garcinia Kola (BitterKola) On Alloxan-Induced Diabetic Rats, World Journal Of Pharmacy And Pharmaceutical Sciences, Vol.3, No.7, pp.08-26.
Souza MR, Diniz Mde F, Medeiros-Filho JE, Araujo, 2012, Metabolic syndrome
and risk factors for non-alcoholic fatty liver disease, Arq. Gastroenterol.vol. 49, pp. 89–96.
Srivastava MP, Tiwari R, Sharma N, 2013, Assessment of phenol and flavonoid
content in the plant materials, Journal on New Biological Reports, vol.2, no.2, pp.163-166
Susanti, H., S.A. Aziz, M. Melati, S. Susanto, 2011, Protein and anthocyanin
production of waterleaf shoots (Talinum triangulare (Jacq.) Willd) at different levels of nitrogen + potassium and harvest intervals. J. Agron. Indonesia. vol.2 , no.39, pp.119-123
Takaki A, Kawai D, Yamamoto K. 2014. Molecular mechanisms and new
treatment strategies for non-alcoholic steatohepatitis (NASH), International Journal of Molecul Science, vol. 15, pp. 7352-7379
Takahashi Y, Fukusato T, 2014, Histopathology of nonalcoholic fatty liver
disease / nonalcoholic steatohepatitis,World Journal of Gastroenteroogy,vol.20, no.42, Nov., pp. 15539-15548
Tijera FH, Caamaño AS, 2015, Pathophysiological mechanisms involved in non-alcoholic steatohepatitis and novel potential therapeutic targets, World Journal of Hepatology,vol. 7,no.10, Jun, pp.1297-1301
Tso, McGill, 2010, The Physiology of the Liver , Gastrointestinal Physiology Valko M, Leibfritz D, Moncola J, Cronin M, Mazura M, dan Telser J, 2007, Free
radicals and antioxidants in normal physiological functions and human disease, The International Journal of Biochemistry & Cell Biology, vol.39, pp. 44–84
Vdoviaková K, Petrovová E, Maloveska M, 2016, Surgical Anatomy of the
Gastrointestinal Tract and Its Vasculature in the Laboratory Ra’,
Gastroenterology Research and Practice Ward JPT, Clarke RW, Linden RWA, 2009,Kelenjar Eksokrin pankreas, Hati, dan
Kandung Empedu, dalam: At A Glance Fisiologi, Erlangga, Jakarta WHO. 2015. Global Health Observatory Data: Overweight and Obesity, [online]
Dari : URL:http://www.who.int/gho/ncd/risk_factors/overweight/en/ [6 Desember 2015]
Williams CD, Stengel J, Asike MI, 2011. Prevalence of nonalcoholic fatty liver
disease and nonalcoholic steatohepatitis among a largely middle-aged population utilizing ultrasound and liver biopsy: a prospective study, Journal of Gastroenterology,vol.140, no.1, pp. 124–131.
Xing Y, Zhang Z, Fu WJ, Zhou DQ, Yuen AC, Daniel Kam-wahMok, Chi-on
Chan,dan Guang-dong Tong, 2016, ‘Shugan Xiaozhi Decoction Attenuates Nonalcoholic Steatohepatitis by Enhancing PPAR𝛼 and L-FABP Expressions in High-Fat-Fed Rats’, Evidence-Based Complementary and Alternative Medicine
Zhang QQ, LU LG, 2015, Nonalcoholic Fatty Liver Disease: Dyslipidemia, Risk
for Cardiovascular Complications, and Treatment Strategy, Journal of Clinical Translational Hepatology , vol. 3, pp.78–84