KARYA TULIS AKHIR

PENGARUH EKSTRAK BIJI KAKAO (THEOBROMA CACAO L.) TERHADAP KUALITAS SPERMATOZOA TIKUS PUTIH (RATTUS

NORVEGICUS) JANTAN YANG DIINDUKSI ALLOXAN SEBAGAI AGEN HIPERGLIKEMIK

Oleh:

Pamela Andria Putri Kusuma Sumarauw 201110330311097

UNIVERSITAS MUHAMMADIYAH MALANG

FAKULTAS KEDOKTERAN

2015

HASIL PENELITIAN

PENGARUH EKSTRAK BIJI KAKAO (THEOBROMA CACAO L.)

TERHADAP KUALITAS SPERMATOZOA TIKUS PUTIH (RATTUS

NORVEGICUS) JANTAN YANG DIINDUKSI ALLOXAN

SEBAGAI AGEN HIPERGLIKEMIK

KARYA TULIS AKHIR

Diajukan kepada

Universitas Muhammadiyah Malang

Untuk Memenuhi Salah Satu Persyaratan

Dalam Menyelesaikan Program Sarjana

Fakultas Kedokteran

Oleh

Pamela Andria Putri Kusuma Sumarauw

201110330311097

UNIVERSITAS MUHAMMADIYAH MALANG

FAKULTAS KEDOKTERAN

2015

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KATA PENGANTAR

Puji syukur saya panjatkan kepada Tuhan Yang Maha Esa, karena atas berkat

dan rahmat-Nya, penulis telah berhasil menyelesaikan penelitian yang

berjudul“Pengaruh Pemberian Ekstrak Biji Kakao (Theobroma Cacao L.) Terhadap

Kualitas Spermatozoa Tikus Putih (Rattus Norvegicus) Jantan Yang Diinduksi

Alloxan Sebagai Agen Hiperglikemik”. Penulisan penelitian ini dilakukan dalam

rangka memenuhi salah satu syarat untuk mencapai gelar Sarjana Kedokteran Jurusan

Pendidikan Dokter pada Fakultas Kedokteran Universitas Muhammadiyah Malang.

Penulis menyadari bahwa penyusunan tugas akhir ini jauh dari sempurna,

walaupun demikian penulis telah berusaha semaksimal mungkin serta mendapatkan

bantuan dan bimbingan dari dosen pembimbing dalam rangka penyusunan. Tanpa

bantuan dan dorongan dari berbagai pihak, sangatlah tidak mudah menjalani masa

perkuliahan hingga pada penyusunan tugas akhir ini.

Akhir kata penulis berharap semoga penelitian ini dapat menambah wawasan

dan bermanfaat bagi semua pihak.

Malang, Februari 2015

Penulis

xi

DAFTAR ISI

Halaman

HALAMAN JUDUL ................................................................................................... i LEMBAR PENGESAHAN ......................................................................................... iii HALAMAN PERNYATAAN ORISINALITAS ..................................................... iv LEMBAR PENGUJIAN ............................................................................................. v KATA PENGANTAR ................................................................................................. vi UCAPAN TERIMA KASIH ...................................................................................... vii ABSTRAK .................................................................................................................... ix ABSTRACT ................................................................................................................... x DAFTAR ISI ................................................................................................................ xi DAFTAR TABEL ........................................................................................................ xiv DAFTAR GAMBAR ................................................................................................... xv DAFTAR SINGKATAN.............................................................................................. xvi DAFTAR LAMPIRAN ......................................................................................... xvii BAB 1 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 ..................................................................................... 3

1.4 Manfaat Penelitian ......................................................................................... 4 1.4.1 Manfaat teoritis ................................................................................... 4 1.4.2 Manfaat aplikatif ................................................................................ 4

BAB 2 TINJAUAN PUSTAKA ................................................................................. 5 2.1 Organ Reproduksi Tikus Jantan ................................................................... 5 2.1.1 Anatomi testis tikus jantan ................................................................. 5 2.1.2 Spermatogenesis …………………………………………………..7 2.1.3 Spermatozoa ........................................................................................ 10 2.2 Pemeriksaan Analisis Semen …………………………………………….12 2.2.1 Pemeriksaaan makroskopis ………………………………………..12 2.2.2 Pemeriksaan mikroskopis .................................................................... 13 2.3 Peroksidasi Lipid Spermatozoa .................................................................... 16 2.4 Diabetes Mellitus ........................................................................................... 17 2.4.1 Definisi ................................................................................................ 17 2.4.2 Klasifikasi ........................................................................................... 18 2.4.2.1 Diabetes mellitus tipe 1 .......................................................... 18 2.4.2.2 Diabetes mellitus tipe 2 .......................................................... 18 2.4.3 Kriteria diagnosis ................................................................................ 18 2.5 Alloxan ........................................................................................................... 19 2.5.1 Definisi ................................................................................................ 19

xii

2.5.2 Peran alloxan dalam pembentukan ROS ........................................... 19 2.6 Pengaruh Alloxan Terhadap kerusakan spermatozoa ................................. 20 2.7 Theobroma Cacao L. (Kakao) ...................................................................... 21 2.7.1 Taksonomi ............................................................................................ 23 2.7.2 Kandungan gizi biji kakao................................................................... 23 2.7.3 Manfaat biji kakao terhadap sistem reproduksi jantan ...................... 24 2.8Metode Ekstraksi ............................................................................................. 25 2.8.1 Definisi ................................................................................................... 25 2.8.2 Jenis metode ekstraksi ........................................................................... 25 BAB 3 KERANGKA KONSEPTUAL DAN HIPOTESIS PENELITIAN .......... 28 3.1 Kerangka Konseptual Penelitian ................................................................... 28 3.2 Hipotesis Penelitian ........................................................................................ 30 BAB 4 METODE PENELITIAN ............................................................................... 31 4.1 Jenis dan Rancangan Penelitian .................................................................... 31 4.2 Lokasi dan Waktu Penelitian ......................................................................... 31 4.3 Populasi dan Sampel ...................................................................................... 31 4.3.1 Populasi ................................................................................................ 31 4.3.2 Sampel .................................................................................................. 31 4.3.3 Besar sampel ........................................................................................ 31 4.3.4 Teknik pengambilan sampel ............................................................... 32 4.3.5 Karakteristik sampel penelitian........................................................... 32 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 Alat dan Bahan Penelitian.............................................................................. 36 4.5 Prosedur Penelitian ......................................................................................... 37 4.6 Kerangka Operasional .................................................................................... 41 4.7 Analisis Data................................................................................................... 42 BAB 5 HASIL PENELITIAN DAN ANALISIS DATA ......................................... 43 5.1 Hasil penelitian .............................................................................................. 43 5.1.1 Kadar gula darah .................................................................................. 43 5.1.2 Kualitas spermatozoa ........................................................................... 45 5.2 Analisis data ................................................................................................... 47 5.2.1 Uji normalitas dan homogenitas ......................................................... 47 5.2.2 Analisis one way anova ....................................................................... 49 5.2.3 Analisis post hoc test ........................................................................... 51 5.2.4 Korelasi pearson .................................................................................. 53 5.2.5 Regresi linier sederhana ..................................................................... 54 BAB 6 PEMBAHASAN ............................................................................................... 60 6.1 Pembahasan .................................................................................................... 60 6.2 Keterbatasan penelitian .................................................................................. 63 BAB 7 KESIMPULAN DAN SARAN ....................................................................... 64

7.1 Kesimpulan ..................................................................................................... 64 7.2 Saran……… ................................................................................................... 64

xiii

DAFTAR PUSTAKA ................................................................................................... 65 LAMPIRAN……….. .................................................................................................... 73

xvii

DAFTAR LAMPIRAN

Lampiran Halaman

1 Gambar hasil penelitian..............................................................................................73

2 Hasil analisis data .......................................................................................................77

3 Dokumentasi Penelitian .............................................................................................90

4 Surat Determinasi Tanaman .......................................................................................91

65

DAFTAR PUSTAKA

Agarwal, A., Prabakaran, S., Said, T., 2005, Prevention of oxidative stress injury

to sperm. J Androl, 26, 60-654

Akbar B, 2010, Reproduksi Hewan Jantan, In: Tumbuhan Dengan Kandungan

Senyawa Aktif Yang Berpotensi Sebagai Bahan Antifertilitas, Adabia Press,

Jakarta, pp 15-17

Al-Haija, 2011, Main Causes of Infertility among Men Treated at Razan Centers

in West Bank: Retrospective study, An-Najah National University, Palestine

American Diabetes Association, 2015, Standards of Medical Care In Diabetes –

2015, The Journal of Clinical And Applied Research And Education, Vol.

38 (1), pp S1-S2

Andujar, M.C, 2012, Review Article: Cocoa Polyphenols and Their Potential

Benefits for Human Health, Facultat de Farmacia University de Valencia,

Spain

Anerao, Sharma, Rahtore, 2010, Studies On Human Sperm Motility and Viability

When Treatment With Rock Salt, Department of Physiology, M.G.M

Medical College, Vol.01, pp 01-10

Arief S, 2012, Radikal bebas, Bulletin Pediatrik Universitas Airlangga, Vol.1, pp

1-9. Surabaya

Ashfahani ED, Wiratmini NI, Sukmaningsih, 2010, Motilitas dan Viabilitas

Spermatozoa Mencit (Mus musculus L) Setelah Pemberian Ekstrak Temu

Putih (Curcuma zedoaria (Berg.) Roscoe), Jurnal Biologi, Vol. XIV (1), pp.

20 – 23

66

Asa Anindito GP, 2013, Pengaruh Pemberian Ekstrak Biji Anggur (Vitis Vinifera

L.) terhadap Motilitas dan Viabilitas Spermatozoa Tikus Putih (Rattus

Norvegicus Strain Wistar) Jantan yang Diberi Paparan Asap Rokok,

Fakultas Kedokteran Universitas Muhammadiyah Malang, Malang

Bashandy AE, 2007, Effect of Fixed Oil of Nigella Sativa on Male Fertilty in

Normal and Hyperlipidemic Rats, International Journal of Pharmacology,

Vol. 2 (1), pp 27-33

Boitrelle et al, 2013, The Nature of Human Sperm Head Vacuoles: A Systematic

Literature Review, Basic and Clinical Andrology, Vol.23 (2)

Chandrashekar, KN., Muralidhara., 2009, Evidence of oxidative stress and

mitochondrial dysfunctions in the testis of prepubertal diabetic rats. [Int J

Impot Res] 2009 May-Jun; Vol. 21 (3), pp. 198-206

Christijanti W, Utami NR, Iswara A, 2010, Efek Pemberian Antioskidan Vitamin

C dan E Terhadap Kualitas Spermatozoa Tikus Putih Terpapar Alletherin,

Biosaintifika, Vol.2 (10), pp. 18 -26

De Jonge, Barratt, 2006, The Sperm Cell : Production, Maturation, Fertilization,

Regeneration, Cambridge University Press, New York

Dewi FY, Anthara MS, Dharmayudha GO, 2014, Efektifitas Ekstrak Daun Sirih

Merah (Piper crocatum) Terhadap Penurunan Kadar Glukosa Darah Tikus

Putih Jantan (Rattus norvegicus) Yang Diinduksi Aloksan, Buletin Veteriner

Udayana, Vol.6 (1)

Dewi Wiryanthini IA, Aman IGM, Bagiada NA, 2012, Pemberian Ekstrak Biji

Kakao (Theobroma cacao L) Menurunkan Kadar Malondialdehide dan

Meningkatkan Kadar NOx Darah Tikus Putih (Rattus Norvegicus) yang

67

Diinduksi Stres Psikososial, Jurnal Ilmiah Kedokteran : Medicina, Vol. 43

(3)

Dharma SH, 2012, Peranan Antioksidan Endogen dan Eksogen Terhadap

Kesehatan, Cermin Dunia Kedokteran, Vol. 39 (10), pp 793 – 794

Dirjen POM, 2000, Paramaeter Standar Umum Ekstrak Tumbuhan Obat, Cetakan

Pertama, Jakarta: Departemen Kesehatan RI, pp 10 - 12

Erniati, Zakaria FR, Priosoeryanto BP, 2012, Efek Konsumsi Minuman Bubuk

Kakao (Theobroma Cacao L.) Bebas Lemak Terhadap Sifat Antioksidatif

Limfosit Subyek Perempuan, Jurnal Tekhnologi dan Industri Pangan, Vol.

XXIII (1), pp 81-85

Erukainure OL, Okafor OY, Obode OC et.al, 2012, Blend of Rossele Calyx and

Selected Fruits Modulates Testicular Redox Status an Sperm Quality of

Diabetic Rats, Journal Diabetes Metabolism,Vol.3(8), pp 214-218

Escriba PV, Nicolson GL, 2014, Membrane Structure and Function: Relevance of

Lipid and Protein Structures In Cellular Physiology, Pathology and

Therapy, Biochimica et Biophysica Acta, Vol. 1838, pp 1449–1450

Esmaeel AK, 2013, Relationships Between Diabetes Mellitus Type 2 and Male

Testosterone Level, Journal of Babylon University/Pure and Applied

Sciences No.(1), Vol.(21)

Evenson DP, Larson KJ, Jost LK, 2002, Sperm Chromatin Structure Assay: Its

Clinical Use for Detecting Sperm DNA Fragmentation In Male Fertility And

Comparisons with Another Techniques, Journal of Andrology, Vol. 23, pp

25 - 43

68

Faranita OV, 2009, Kualitas Spermatozoa Pada Tikus Wistar Jantan Diabetes

Mellitus, Fakultas Kedokteran Universitas Diponegoro, Semaran

Fauci A, Braunwald E, Kasper D, Hauser S, 2008, Harrison's Principles of

Internal Medicine 17th Edition, McGraw-Hill Medical, New York

Hafiz, R, 2008, Artikel Karya Ilmiah : Pengaruh Pemberian Minyak Jinten Hitam

(Nigella sativa)Terhadap Morfologi Spermatozoa Mencit Yang Diinduksi

oleh Alloxan, Fakultas Kedokteran Universitas Diponegoro, Semarang

Hertansa RM, 2010, Pengaruh Pemberian Dutch Style Cocoa Powder Terhadap

Kadar Glukosa Darah Tikus Putih (Rattus norvegicus) yang Diinduksi

Alloxan, Fakultas Kedokteran Universitas Sebelas Maret, Surakarta

Hidayah, Nurul, 2007, Identifikasi dan Pengelolaan Stress Infertil, Konferensi

Nasional Stress Management dalam Berbagai Setting Kehidupan, Bandung

Hii CL, Law CL, Suzannah S, Misnawi, Cloke M, 2009, Polyphenols in Cocoa

(Theobroma cacao L), Asian Journal of Food and Agro-Industry, Vol. 2 (4),

pp 702 – 722

Inveresk Research, 2000, Rat Sperm Morphological Assesment, Industrial

Reproductive Toxicology Discussion Group, Vol.1, pp 6 – 13

Karmawati E, Mahmud Z, Syakir M, Rubiyo, 2010, Budidaya dan Pasca Panen

Kakao, Pusat Penelitian dan Pengembangan Perkebunan, diunduh pada 16

September 2014 (perkebunan.litbang.deptan.go.id)

Khardori R, 2013, Changing Paradigm In Type 2 Diabetes Mellitus, Indian

Journal of Endocrinology and Metabolism, pp 68-71

69

Maneesh, M., 2006, Impaired Hypothalamic-Pituitary-Gonadal Axis Function in

Men With Diabetes Mellitus, Indian Journal of Clinical Biochemistry,

Vol.21 (1), pp 165-168

Meldawati, 2011, Pengaruh Ekstrak Buah (Morinda Citrifolia Linn) Terhadap

Kualitas, Kuantitas Sperma Dan Kadar Malondialdehyde Testis Tikus

Wistar Diabetes Mellitus, Fakultas Kedokteran Universitas Sumatera Utara,

Medan

Miyamoto, T, Tsujimura A, Miyagawa Y, Namiki M, 2012, Review Article : Male

infertility and Its Causes in Human, Advances in Urology Ashikawa

Medical University, Japan

Muchtadi D, 2013, Antioksidan & Kiat Sehat di Usia Produktif, Alfabeta,

Bandung

Nawaekasari M, 2012, Efek Senyawa Polifenol Ekstrak Biji Kakao (Theobroma

cacao L) Terhadap Pertumbuhan Bakteri Lactobacillus acidophilus,

Fakultas Kedokteran Gigi Universitas Jember

Nugroho AE, 2006, Hewan Percobaan Diabetes Mellitus: Patologi dan

Mekanisme Aksi Diabetogenik, Biodiversitas, 7(4), 378-382.

Oliveira H, Marcello S, Santos C, 2009, Adverse Effect of Cadmium Exposure On

Mouse Sperms, Reproductive Toxicology, Elsevier Ltd, Vol. 28, pp 550-555

Oryza Oil & Fat Chemical CO LTD, 2011, Cocoa Extract : Ingredient For

Weight Management with Natural Antioxidants, Tokyo

Paoletti R, Polli A, Conti A, Visioli F, 2011, Chocolate and Health, Springer,

Milan

70

Pebrianti Lina NM, 2011, Kualitas Spermatozoa Mencit Jantan Dewasa (Mus

musculus L.) Setelah Diberikan Monosodium Glutamat (MSG), Jurnal

Simbiosis Udayana, Vol. 1 (1), pp. 40 – 50

PERKENI, 2007, Guidelines For Management of Postmeal Glucose

Porbowaseso, 2014, Ekstraksi Polifenol Biji Kakao Secara Kimiawi Sebagai

Antioksidan dan Pewarna Alami, Fakultas Teknologi Pertanian Universitas

Jember, Jember

Purwaningsih, Agung W, Megaputera I, 2013, Formulasi Sediaan Ekstrak Etanol

Biji Kakao (Theobroma Cacao L.) Sebagai Kandidat Natural Antioxidant

Melalui Teknologi Mikroenkapsulasi Dengan Metode Spray-Drying,

Fakultas Farmasi Universitas Hasanuddin, Makasar (artikel.dikti.go.id

diunduh tanggal 18 Okteber 2014)

Septiana AT, Asnani A, 2012, Kajian Sifat Fisikokimia Ekstrak Rumput Laut

Coklat (Sargassum Duplicatum) Menggunakan Berbagai Pelarut Dan

Metode Ekstraksi, Jurnal AGROINTEK, Vol. 6(1), pp 22-28

Setiawan M, 2008, Buku Ajar Endokrin, Bab 2:17, UMM Press, Malang

Sherwood L, 2007, Human Physiology: From Cells To System 6thEdition, Chapter

20:819-824, EGC, Jakarta

Smit M, 2011, Clinical Application of Sperm Chromatin Structure Assesment in

Andrology Patients, Erasmus Universiteit Rotterdam, Rotterdam

Snell R, 2006, Anatomi Klinik untuk Mahasiswa Kedokteran Edisi 6, Bab 7:349-

350, EGC, Jakarta

Supranto J, 2007, Teknik Sampling untuk Survei dan Eksperimen, Rineka Cipta,

Jakarta

71

Tanagho E. A., McAninch, J. W., 2008. Smith's General Urology Vol. 17, Bab

44:689-691, McGraw-Hill Medical, New York

Tapas AR, Sakarkar DM, Kakde RB, 2008, Flavonoids as nutraceuticals: A

review, Tropical Journal of Pharmaceutical, Vol.7(3), pp 89-93

Trindade A, Simoes A, Silva R et.al, 2013, Long Term Evaluation of

Morphometric and Ultrastructural Changes of Testes of Alloxan-induced

Diabetic Rats, Acta Cirurgica Brasileira, Vol.28(4), pp 256-265

Twsigye CK, 2011, Cell Biology And Genetics, Chapter 4:23-24 African Virtual

University, Africa

WHO, 2011, Laboratory Manual For The Examination and Processing of Human

Semen, Edisi 5, pp 22

Wibisono H, 2010, Buku Pertama : Panduan Laboratorium Andrologi, Bab 1:7-

10, Refika Aditama, Bandung.

Widowati, 2008, Potensi Antioksidan Sebagai Anti Diabetes, Jurnal Kesehatan

Masyarakat, Vol.7 (2), pp 1 – 10

Winarni S, Judiwati R, Prajogo B, Hayati A, 2011, Fraksi Etanol 96% Biji Koro

Benguk (Mucuna pruriens L.) Sebagai Peningkat Kualitas Spermatozoa

Mencit (Mus Musculus), Jurnal Kesehatan Reproduksi, Vol.1 (2), pp 60 – 66

Winarsi H, 2007, Antioksidan Alami dan Radikal Bebas, Kanisius, Yogyakarta

Yudiarti T, Widiastuti E, Pratikno H, 2004, Buku Ajar Biologi, Fakultas

Peternakan Universitas Diponegoro, Semarang

Yulianto RA, Isnaeni W, Susanti R, 2013, Pengaruh Pemberian Vitamin E

Terhadap Kualitas Sperma Tikus Putih Yang Dipapar Timbal, Unnes

Journal of Life Science, Vol.2 (2)

72

Yuriska A, 2009, Efek Aloksan Terhadap Kadar Glukosa Darah Tikus Wistar,

Fakultas Kedokteran Universitas Diponegoro, Semarang

Zadda A, 2009, Pengaruh Diet Rumput Laut Eucheuma Sp. Terhadap Jumlah

Eritrosit Tikus Wistar dengan Diabetes Aloksan, Fakultas Kedokteran

Universitas Diponegoro, Semarang

Zare S, Rahmani Y, Eftekhaari TE, Faramarzi A, 2013, Role of oxidative stress in

Male infertility, International Electronic Journal of Medicine (IEJM), Vol. 2

(2), pp 77-81