oleh: muhammad hamzah asadullah 201110330311023 · acs : acute coronary syndrome atp : adenosine...
TRANSCRIPT
KARYA TULIS AKHIR
PENGARUH PEMBERIAN EKSTRAK BIJI BUAH PINANG (Areca
catechu L.) TERHADAP PROFIL LIPID TIKUS PUTIH JANTAN (Strain
wistar) MODEL ATEROSKLEROSIS
Oleh:
MUHAMMAD HAMZAH ASADULLAH
201110330311023
FAKULTAS KEDOKTERAN
UNIVERSITAS MUHAMMADIYAH MALANG
2015
KATA PENGANTAR
Assalamu’alaikumWr. Wb.
Puji syukur kehadirat Allah SWT yang telah memberikan rahmat serta
taufiknya sehingga penyusun dapat menyelesaikan usulan penelitian yang
berjudul “PENGARUH PEMBERIAN EKSTRAK BIJI BUAH PINANG (Areca
catechu L.) TERHADAP PROFIL LIPID TIKUS PUTIH JANTAN (Strain
wistar) MODEL ATEROSKLEROSIS” dengan baik. Usulan penelitian ini
disusun untuk diajukan sebagai salah satu persyaratan untuk menyelesaikan tugas
akhir program sarjana Fakultas Kedokteran Universitas Muhammadiyah Malang.
Penulis mengucapkan terimakasih kepada :
1. dr. Irma Suswati, M. Kes. selaku Dekan Fakultas Kedokteran UMM
2. dr. Diah Hermayanti, Sp.PK selaku Dosen Pembimbing I yang telah
membantu, membimbing, dan mengarahkan penulis dalam
menyelesaikan usulan penelitian ini.
3. dr. Djaka Handaja, MPH selaku Dosen Pembimbing II yang telah
membantu, membimbing, dan mengarahkan penulis dalam
menyelesaikan usulan penelitian ini.
4. Kedua orang tua penulis, Ayahanda dr. Widi Cipto Basuki, MKP dan
Ibunda dr. Sri Mustikaning Batin Sulistyowati yang selalu
mendukung penulis dalam menyelesaikan penelitian ini.
5. Dita Ratnasari Wahyuningrum yang selalu membantu saat penulis
mengalami kesulitan dalam segala hal untuk menyelesaikan tugas
akhir ini.
6. Teman-teman satu angkatan FK UMM, Kakak tingkat FK UMM, dan
pihak lain yang tidak dapat penulis sebutkan satu persatu.
Penulis menyadari bahwa tak ada gading yang takretak, masih banyak
terdapat kekurangan dalam susunan usulan penelitian ini. Untuk membuat usulan
penelitian ini menjadi lebih baik, penulis selalu mengharapkan kritik dan saran
dari para pembaca.Akhir kata, terimakasih atas perhatiannya.Semoga usulan
penelitian ini dapat bermanfaat bagi kita semua. Amin Yaa Robbal ‘Alamin.
Wassalamu’alaikumWr. Wb.
Malang, 27 Januari 2015
penulis
ABSTRAK
Hamzah Asadullah, Muhammad. 2015. Pengaruh Pemberian Ekstrak Biji Buah
Pinang (Areca catechu L.) Terhadap Profil Lipid Tikus Putih Jantan (Strain
wistar) Model Aterosklerosis. Tugas Akhir, Program Studi Pendidikan
Dokter Fakultas Kedokteran Universitas Muhammadiyah Malang.
Pembimbing: (1) dr. Diah Hermayanti, Sp.PK (2) dr. Djaka Handaja, MPH.
Latar Belakang : Perubahan pola makan masyarakat saat ini meningkatkan
terjadinya dislipidemia. Dislipidemia merupakan faktor risiko Penyakit Jantung
Koroner (PJK). Dalam biji buah pinang (Areca catechu L.) terdapat flavonoid
yang mana memperbaiki profil lipid.
Tujuan Penelitian : Untuk mengetahui pengaruh pemberian ekstrak biji buah
pinang (Areca catechu L.) terhadap perubahan profil lipid (HDL, LDL, TG,
Kolesterol Total) tikus model aterosklerosis.
Metodologi Penelitian : Menggunakan true experiments post test only control
group design. Analisis data menggunakan uji Oneway ANOVA, korelasi dan
regresi.
Hasil Penelitian dan Diskusi : Uji oneway ANOVA, menunjukkan nilai
signifikansi <0,05 sehingga disimpulkan bahwa terdapat perbedaan yang
signifikan rata-rata profil lipid (HDL, LDL, TG, kolesterol total). Hasil uji
korelasi menunjukkan cholesterol total (r=-0.765, p=0.000), TG (r= -0.705,
p=0.000) dan LDL (r= -0.774, p=0.000) mempunyai korelasi yang signifikan
(p<0.05) dengan arah korelasi negatif, berarti semakin tinggi dosis ekstrak biji
buah pinang akan menurunkan kolesterol total, LDL, dan TG. Sebaliknya, HDL
(r= 0.642, p=0.001) mempunyai arah korelasi positif yang berarti semakin tinggi
dosis ekstrak biji buah pinang akan meningkatkan kadar HDL.
Kesimpulan : Pemberian ekstrak biji buah pinang (Areca catechu L.) dapat
meningkatkan HDL serta menurunkan LDL, TG, dan kolesterol total.
Kata Kunci : Biji buah pinang, Aterosklerosis, Profil Lipid, Flavonoid.
ABSTRACT
Hamzah Asadullah, Muhammad. The effect of Areca catechu L. seed extract on
lipid profile in white rats (Strain wistar) with atherosclerosis model.
Final Project, Medical Faculty, University of Muhammadiyah Malang.
Advisors: (1) dr. Diah Hermayanti, Sp.PK (2) dr. Djaka Handaja, MPH.
Background: Changes in today’s society diet increases the incidence of
dyslipidemia. Dyslipidemia is the main risk factor for Coronary Heart Disease
(CHD). In a study said that Areca catechu L. contains flavonoid that could repair
lipid profile.
Objective: To prove the effect of Areca catechu L. seed extract on lipid profile in
white rats (Strain wistar) with atherosclerosis model.
Methods: Using true experiments post test only control group design. The data
analysis using oneway ANOVA, correlation, and regression test.
Result and Discussion: The result of oneway ANOVA, showed that signification
score <0,05 it can be concluded that there are significant differences in lipid
profile average (HDL, LDL, TG, total cholesterol). The result of correlation test
of cholesterol total showed that (r=-0.765, p=0.000), TG (r= -0.705, p=0.000)
dan LDL (r= -0.774, p=0.000) has significant correlation (p<0.05) with negative
correlation direction that means increasing dose of Areca catechu L. seed extract
can decrease total total cholesterol, LDL, and TG. Otherwise, HDL (r=0.642,
p=0,001) has positive correlation that means increasing dose of Areca catechu L.
seed can increase HDL.
Conclusion: Areca catechu L. seed extract can increase HDL and decrease LDL,
TG, and total cholesterol.
Keywords: Areca catechu L. seed, Atherosclerosis, Lipid profile, Flavonoid.
DAFTAR ISI
HALAMAN JUDUL ............................................................................................ i
HALAMAN PERSETUJUAN .............................................................................. ii
HALAMAN PENGESAHAN .............................................................................. iii
KATA PENGANTAR ......................................................................................... iv
ABSTRAK ........................................................................................................... vi
ABSTRACT ........................................................................................................ vii
DAFTAR ISI ..................................................................................................... viii
DAFTAR TABEL .............................................................................................. xii
DAFTAR GAMBAR ....................................................................................... xiii
DAFTAR SINGKATAN .................................................................................. xiv
DAFTAR LAMPIRAN ..................................................................................... xv
BAB 1 : PENDAHULUAN ............................................................................... 1
1.1 ............................................................................................................ La
tar Belakang ................................................................................................ 1
1.2 ............................................................................................................ Ru
musan Masalah ............................................................................................ 3
1.3 ............................................................................................................ Tu
juan Penelitian ............................................................................................. 3
1.3.1 Tujuan Umum .................................................................................... 3
1.3.2 Tujuan Khusus .................................................................................... 3
1.4 Manfaat .............................................................................................. 3
1.4.1 Untuk Akademik ............................................................................... 3
1.4.2 Untuk Klinis ...................................................................................... 4
1.4.3 Untuk Masyarakat ............................................................................. 4
BAB 2 : TINJAUAN PUSTAKA ...................................................................... 5
2.1 Lipid ............................................................................................................ 5
2.1.1 definisi Lipid ...................................................................................... 5
2.1.2 Fungsi Lipid ........................................................................................ 5
2.1.3 Jenis Lipid dan Lipoprotein ................................................................. 5
2.1.3.1 Kilomikron .............................................................................. 6
2.1.3.2 Very Low Density Lipoprotein (VLDL) ................................. 6
2.1.3.3 Intermediate Density Lipoprotein (IDL) ................................. 7
2.1.3.4 Low Density Lipoprotein (LDL) .............................................. 7
2.1.3.5 High Density Lipoprotein (HDL) ............................................ 7
2.1.3.6 Trigliserida .............................................................................. 9
2.1.4 Profil Lipid .......................................................................................... 10
2.1.5 Transpor Lipid .................................................................................... 10
2.1.5.1 Jalur Eksogen .......................................................................... 10
2.1.5.2 Jalur Endogen ......................................................................... 11
2.1.5.3 Jalur Reverse Cholesterol Transport ...................................... 13
2.1.6 Dislipidemia ........................................................................................ 14
2.2 Aterosklerosis ............................................................................................... 14
2.3 Pinang (Areca catechu L.) ............................................................................. 17
2.3.1 Deskripsi ............................................................................................. 17
2.3.2 Kandungan Kimia Pinang ................................................................... 19
2.3.3 Manfaat Buah Pinang ......................................................................... 21
2.3.4 Berbagai Penelitian Tentang Pinang ................................................... 23
2.4 Flavonoid ...................................................................................................... 24
2.4.1 Flavonoid Sebagai Terapi Anti Hiperlipidemia ................................... 24
2.4.2 Hubungan Flavonoid Dengan Profil Lipid ........................................... 25
BAB 3 : KERANGKA KONSEPTUAL DAN HIPOTESIS ............................ 27
3.1 Kerangka Konseptual Penelitian ................................................................. 27
3.2 Hipotesis ...................................................................................................... 30
BAB 4 : METODOLOGI PENELITIAN .......................................................... 31
4.1 Rancangan Penelitian .................................................................................. 31
4.2 Tempat dan Waktu Penelitian ..................................................................... 31
4.3 Populasi dan Sampel ................................................................................... 31
4.3.1 Populasi .............................................................................................. 31
4.3.2 Sampel ................................................................................................ 31
4.3.3Estimasi Besar Sampel ......................................................................... 31
4.3.4 Teknik Sampling ................................................................................. 32
4.3.5 Karakteristik Sampel Penelitian ........................................................ 33
4.3.6 Variabel Penelitian ............................................................................ 33
4.3.6.1 Variabel Bebas ...................................................................... 33
4.3.6.2 Variabel Tergantung .............................................................. 33
4.3.7 Definisi Operasional .......................................................................... 33
4.4 Diet Aterogenik ........................................................................................... 34
4.5 Dasar Penentuan Dosis Buah Pinang ............................................................ 34
4.6 Bahan dan Instrumen Penelitian .................................................................. 35
4.6.1 Bahan ................................................................................................. 35
4.6.2 Alat ..................................................................................................... 36
4.7 Prosedur Penelitian ....................................................................................... 36
4.7.1 Pembagian Kelompok Tikus .............................................................. 37
4.7.2 Adaptasi ............................................................................................ 37
4.7.3 Pemberian Diet Normal dan Diet Aterogenik ................................... 37
4.7.4 Pemberian Ekstrak Biji Buah Pinang ................................................. 38
4.8 Sampel Darah ................................................................................................ 38
4.9 Pemeriksaan HDL, LDL, TG, Kolesterol Total ............................................ 38
4.10 Alur Penelitian ............................................................................................ 39
4.11 Analisis Data ............................................................................................... 39
BAB 5 : HASIL PENELITIAN DAN ANALISIS DATA ................................. 41
5.1 Hasil Penelitian ............................................................................................. 41
5.2 Analisis Data ................................................................................................. 44
5.2.1 Uji Normalitas ...................................................................................... 44
5.2.2 Uji Homogenitas .................................................................................. 44
5.2.3 Uji Korelasi .......................................................................................... 45
5.2.4 Uji Regresi ........................................................................................... 46
5.2.5 Uji Oneway ANOVA ........................................................................... 50
BAB 6 : PEMBAHASAN ................................................................................... 52
BAB 7 : KESIMPULAN DAN SARAN ............................................................ 58
DAFTAR PUSTAKA ........................................................................................ 59
LAMPIRAN ........................................................................................................ 68
DAFTAR TABEL
Tabel Halaman
2.1 Hasil Ekstraksi dan Isi Dari Total Fenolik dan Flavonoid di
Ekstrak Biji Buah Pinang ....................................................................... 20
4.1 Konversi Dosis Antar Spesies ................................................................ 34
5.1 Tabel data lipid (Cholesterol total, trigliserida, HDL, dan LDL) .......... 43
5.2 Uji Normalitas ........................................................................................ 44
5.3 Uji Homogenitas .................................................................................... 45
5.4 Uji Korelasi Pearson .............................................................................. 46
5.5 Uji Regresi ............................................................................................. 49
5.6 Uji Oneway ANOVA Cholesterol Total ................................................ 51
5.7 Uji Oneway ANOVA TG ....................................................................... 51
5.8 Uji Oneway ANOVA HDL .................................................................... 51
5.9 Uji Oneway ANOVA LDL .................................................................... 51
DAFTAR GAMBAR
Gambar Halaman
2.1 Jalur Reverse cholesterol transport ...................................................... 14
2.2 Proses Pembentukan Aterosklerosis .................................................... 16
2.3 Biji Buah Pinang .................................................................................. 18
5.1 Grafik Rata-Rata Profil lipid (HDL, LDL, TG, Kolesterol
total) Tiap Kelompok ........................................................................... 42
5.2 Grafik Rata-Rata Tiap Spesimen Profil Lipid ...................................... 43
5.3 Grafik linier regresi profil lipid (HDL, LDL, TG, kolesterol
total) ..................................................................................................... 50
DAFTAR SINGKATAN
ABCA1 : ATP binding cassette – A1
ACS : Acute Coronary Syndrome
ATP : Adenosine Triphosphate
CAD : Coronary Artery Disease
CETP : Cholesterol Ester Transfer Protein
CHOD-PAP : Cholesterol Oxidase Phenol Aminophenazone
CSA : Chronic Stable Angina
GPO-PAP : Glucose Oxidase Phenol Aminophenazone
HDL : High Density Lipoprotein
HMG Co-A Reductase : 3-Hidroksi 3-Metilglutaril Koenzim A
IDL : Intermediatte Density Lipoprotein
LCAT : Lecithin Cholesterol Acyl Transferase
LDL : Low Density Lipoprotein
LPL : Lipoprotein Lipase
PJK : Penyakit Jantung Koroner
SR-BI : Scavenger Receptor Class BI
TEE : Trans Esofageal Ekokardiografi
TG: Trigliserida
VLDL : Very Low Density Lipoprotein
DAFTAR LAMPIRAN
Lamipran Halaman
Lampiran 1 Hasil Analisis Data ................................................................ 68
Lampiran 2 Foto Penelitian ....................................................................... 84
Lampiran 3 Determinasi Areca catechu L. ............................................... 88
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