KARYA TULIS AKHIR

Pengaruh Pemberian Ekstrak Daun Ketapang (Terminalia catappa L.) Terhadap Profil

Lipid (HDL, LDL, TG, Kolesterol Total) Tikus Putih Jantan (Strain wistar) Model

Dislipidemia

Oleh :

Hilmy Asyam Farisy

201310330311067

FAKULTAS KEDOKTERAN

UNIVERSITAS MUHAMMADIYAH MALANG

2018

LEMBAR PENGESAHAN

LAPORAN HASIL PENELITIAN

Telah disetujui sebagai hasil penelitian

untuk memenuhi persyaratan

Pendidikan Sarjana Fakultas Kedokteran

Universitas Muhammadiyah Malang

Tanggal : 16 April 2018

Pembimbing I

Dr. dr. Meddy Setiawan, Sp.PD

Pembimbing II

dr. Rubayat Indradi, MOH

Mengetahui,

Fakultas Kedokteran Universitas Muhammadiyah Malang

Dekan,

Dr. dr. Meddy Setiawan, Sp.PD

KATA PENGANTAR

Assalamu’alaikum Warahmatullah Wabarakatuh

Puji syukur kehadirat Allah SWT yang Maha Pengasih lagi Maha Penyayang atas

nikmat Iman dan Islam serta nikmat kesehatan dan kesempatan, atas izin Allah SWT penulisan

tugas akhir ini dapat selesai dengan baik. Shalawat serta salam semoga senantiasa tercurahkan

kepada Rasulullah Muhammad SAW.

Penelitian tugas akhir ini berjudul “Pengaruh Pemberian Ektrak Daun Ketapang

(Terminalia catappa L.) Terhadap Profil Lipid (HDL, LDL, TG, Kolesterol Total) Tikus Putih

Jantan (Strain wistar) Model Dislipidemia.

”. Tugas akhir ini diajukan untuk memenuhi persyaratan Pendidikan Sarjana Fakultas

Kedokteran Universitas Muhammadiyah Malang.

Penulis menyadari tugas akhir ini masih jauh dari kata sempurna, oleh karena itu,

penulis sangat mengharapkan saran dan masukan yang membangun. Semoga karya tulis ini

dapat menambah wawasan keilmuan dan bermanfaat bagi para pencari ilmu.

Wassalamu’alaikum Warahmatullah Wabarakatuh

Malang, 16 April 2018

Penulis

DAFTAR ISI

Halaman

Lembar Pengajuan ................................................................................................i

Lembar Pengesahan..............................................................................................ii

Lembar Pengujian................................................................................................iv

Kata Pengantar.....................................................................................................v

Abstrak...............................................................................................................viii

DAFTAR ISI........................................................................................................ x

DAFTAR TABEL ............................................................................................ xiv

DAFTAR GAMBAR ......................................................................................... xv

DAFTAR SINGKATAN .................................................................................... vi

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 akademis .............................................................. 4

1.4.2 Manfaat klinis .................................................................... 4

1.4.3 Manfaat bagi masyarakat ................................................... 4

BAB 2 TINJAUAN PUSTAKA ................................................................... 5

2.1 Lipid ............................................................................................. 5

2.1.1 Definisi lipid ...................................................................... 5

2.1.2 Jenis lipid ........................................................................... 5

2.1.3 Profil lipid .......................................................................... 8

2.1.4 Transpor lipid ..................................................................... 9

2.2 Dislipidemia.............................................................................11

2.2.1 Klasifikasi Dislipidemia....................................................12

2.3 Flavonoid..................................................................................13

2.3.1 Hubungan Flavonoid Dengan Profil Lipid........................14

2.4 Tanaman Ketapang .................................................................... 15

2.4.1 Klasfikasi dan Morfologi ................................................. 15

2.4.2 Kandungan zat aktif daun ketapang ................................. 16

2.4.3 Manfaat Tumbuhan Ketapang .......................................... 17

BAB 3 KERANGKA KONSEP & HIPOTESIS PENELITIAN ............ 18

3.1 Kerangka Konseptual Penelitian ................................................ 18

3.2 Hipotesis..................................................................................... 21

BAB 4 METODE PENELITIAN .............................................................. 22

4.1 Jenis Penelitian ........................................................................... 22

4.2 Lokasi dan Waktu Penelitian ..................................................... 22

4.3 Populasi dan Sampel .................................................................. 22

4.3.1 Populasi ............................................................................ 22

4.3.2 Sampel.............................................................................. 22

4.3.3 Replikasi Sampel ............................................................. 23

4.3.4 Teknik Pengambilan Sampel ........................................... 24

4.3.5 Karakteristik Sampel Penelitian ....................................... 24

4.3.6 Variabel Penelitian............................................................25

4.3.7 Definisi Operasional..........................................................25

4.4 Bahan dan Instrumen Penelitian ................................................ 26

4.4.1 Instrumen ......................................................................... 26

4.4.2 Bahan ............................................................................... 26

4.5 Prosedur Penelitian .................................................................... 27

4.5.1 Proses Pembuatan Pakan.................................................. 27

4.5.2 Proses Pembuatan Ekstrak ............................................... 27

4.5.3 Pembedahan dan Pengambilan Sampel Darah ................. 28

4.5.4 Pemeriksaan Kadar Profil lipid.........................................28

4.6 Alur Penelitian............................................................................29

4.7 Analisis Data...............................................................................30

4.8 Jadwal Penelitian.........................................................................31

BAB 5 HASIL DAN ANALISIS DATA PENELITIAN ......................... 32

5.1 Hasil penelitian .......................................................................... 32

5.2 Analisis Data .............................................................................. 33

BAB 6 PEMBAHASAN ............................................................................. 46

BAB 7 KESIMPULAN DAN SARAN ...................................................... 51

DAFTAR PUSTAKA ........................................................................................ 52

LAMPIRAN........................................................................................................53

DAFTAR TABEL

Tabel Halaman

2.1 Klasifikasi Lipid Plasma ................................................................................ 9

5.1 Hasil rerata pengukuran kadar profil lipid darah tikus wistar pada berbagai kelompok

dalam mg/dl ................................................................................................. 32

5.2 Hasil Uji Normalitas .................................................................................... .34

5.3 Hasil Uji Homogenitas ................................................................................. .34

5.4 Hasil Uji Anova............................................................................................. 35

5.5 Hasil Uji Post Hoc Kolesterol Total...............................................................36

5.6 Hasil Uji Post Hoc Trigliserida.......................................................................37

5.7 Hasil Uji Post Hoc HDL.................................................................................38

5.8 Hasil Uji Post Hoc LDL..................................................................................39

5.9 Hasil Uji Korelasi............................................................................................40

5.10 Hasil Uji Regresi...........................................................................................41

DAFTAR GAMBAR

Gambar Halaman

2.1 Daun dan Bunga Tumbuhan Ketapang ............................................ 15

2.2 Contoh Struktur Kimia Flavonoid C6-C3-C6...................................17

5.1 Grafik Rata-Rata Pengukuran Kadar Profil lipid Darah Tikus ........ 33

DAFTAR SINGKATAN

AHA : American Heart Association

ATP : Adenosine triphosphate

DNA : deoxyribonucleic acid

HDL : High Density Lipoprotein

LDL : Low Density Lipoporotein

MRNA : Messenger ribonucleic acid

OH : hydroxide

Riskesdas : Riset Kesehatan Dasar

ROS : reactive oxygen species

SOD : superoxide dismutase

WHO : world health organization

DAFTAR PUSTAKA

Adam, john MF, Sudoyo, W, Setyohadi, et al, 2009. Dislipidemia dalam Buku Ajar

Ilmu Penyakit Dalam, edisi V, Interna Publishing, Jakarta. hal. 1984 – 1986.

Alegret, M., Silvestre, J.S. 2006. Pleiotropic effects of statins and related

pharmacological experimental approaches. Methods Find Exp Clin Pharmacol.

28(9): 627.

Ambidevi, Sharma. 2014. Anti-Obesity And Anti-Hyperlipidemic Activity Of

Terminalia Catappa Linn, In High-Fat-Diet Indiuced Obese Rats. Asian Journal

of Pharmaceutical Research and Development, Mumbai. Vol 1(6)

Anggraeni, C.D. 2009. Pengaruh pemberian angkak terhadap kadar kolestrol total darah

tikus putih (Rattus novergicus). Cermin Dunia Kedokteran 36: 94-95

Apak, R. et.al. 2007, ‘Comparative Evaluation of Various Total Antioxidant Capacity

Assays Applied to Phenolic Compounds with the CUPRAC Assay’,

Molecules, 1496-1547

Arief, M. I., Et.Al. 2012, ‘Potensi Bunga Karamunting (Melastoma malabathricum

L.)Terhadap Kadar Kolesterol Total Dan Trigliserida Pada Tikus Putih

Jantan Hiperlipidemia Yang Diinduksi Propiltiourasil’, Prestasi,

Volume 1, Nomor 2.

Badan penelitian dan pengembangan kesehatan kementrian kesehatan RI. 2013.

Laporan nasional Riset Kesehatan Dasar (Riskesdas) 2013. Hal. 93.

Botham, Kathleen M & Mayes, Peter A. 2009. Cholesterol Syntesis, Transport &

Excretion. In: Harper’s illustrated Biochemistry.28th Ed. USA: LANGE Mc

Graw Hill. chapter 26. p 224-233.

Casaschi, A., Maiyoh, G. K., Rubio, B. K., et al, 2004. The Chalconexanthohumol

Inhibits Triglyceride and Apolipoprotein B Secretion In HepG2 Cells. Journal

of Nutrition. 134. pp. 1340-1346.

Dalimartha, S. 2014. Tumbuhan Sakti Atasi Kolesterol. Jakarta: Penebar Swadaya

Group. Hal 3-4.

Dalimartha, S. 2008. Atlas Tumbuhan Obat Indonesia Jilid 3. Jakarta: Perpustakaan

Nasional Republik Indonesia. http://www.americanheart.org. Diakses tanggal 1

September 2016

Dewi, Rismala. 2007. (online) http://bahan-alam.fa.itb.ac.id/detail.php?id=184 diakses

tanggal 25 Mei 2016.

Fatmawati, E. 2008. Pengaruh Lama Pemberian Ekstrak Daun Sambiloto

(Andrographispaniculata ness.) Terhadap Kadar Kolesterol, LDL (Low Density

Lipoprotein), HDL (High Density Lipoprotein) dan Trigliserida Darah Tikus

(Rattusnorvegicus) Diabetes. Skripsi. Fakultas Sains Dan Teknologi.

Universitas Islam Negeri Maulana Malik Ibrahim Malang.

FKUI, 2007, Farmakologi dan Terapi, Edisi 5, Departemen Farmakologi dan

Terapeutik Fakultas Kedokteran Universitas Indonesia, Balai Penerbit FKUI,

Jakarta. Hal 820-821.

Graha, K.C. 2010. 100 Questions & Answers Kolesterol. Jakarta: PT Elex Media

Komputido Gramedia. Hal 16-18.

Gilman, A.G., 2007, Goodman & Gilman Dasar Farmakologi Terapi, diterjemahkan

oleh Tim Alih Bahasa Sekolah Farmasi ITB, Edisi X, 877, Penerbit Buku

Kedokteran, EGC, Jakarta.

Guyton A.C. and J.E. Hall 2007. Buku Ajar Fisiologi Kedokteran. Edisi 9.

Jakarta: EGC. 74,76, 80-81, 244, 248, 606,636,1070,1340.

Halliwell, B. and Gutteridge, J. M. C. 2007. Free Radicals in Biology and Medicine.

Oxford: Oxford University Press dalam Henry, J. 2014. Advances in Food and

Nutrition Research. Volume 71-Academic Press

Harini, M., DA, Okid. 2009. Blood Cholesterol Level of Hypercholesterolemia Rat

(Rattus norvegicus) After VCO Treatment. Journal Bioscience Vol 1 No 2 : 53-

58

Hartoyo, A., N Dahrulsyah,. Sripalupi dan P. Nugroho. 2008. Pengaruh Fraksi

Karbohidrat Kacang Komak (Lablab Purpureus (L) Sweet). Jurnal teknologi

dan industri pangan, 19: 25-31

Herwiyarirasanta., BA, Eduardus. 2010. Effect of Black Soybean Extract

Supplementation in Low Density Lipoprotein Level of Rats (Rattus norvegicus)

With High Fat Diet. Science Article Universitas Airlangga. Surabaya. Vol 10.

No 1 : 3.

Hwang YP, Choi JH, Yun HJ, et al, 2011, Anthocyanins from purple sweet potato

attenuate dimethylnitrosamine-induced liver injury in rats by reducing Nrf2-

mediated antioxidant enzymes and reducing COX-2 and iNOSpexpression, Food

and Chemical Toxicology, 49, pp. 93-99

Indriasari, Ira. 2012. Ekstrak Ethanol Buah Naga Merah (Hylocereus polyrhizus)

Memperbaiki Profil Lipid Pada Tikus Wistar Jantan (Rattus Novergicus)

Dislipidemia. Tesis. Fakultas Kedokteran. Universitas Udayana. Denpasar. Hal

108-109.

Lamson, Davis W, MS, ND, and Brignall, Matthew S. ND. 2000. Antioxidants and

cancerIII: Quercetin. Alternative Medicine Review Volume 5 Number 3

Marks Dawn B, Marks Allan D, Smith Colleen M., 2000, Biokimia Kedokteran Dasar

: Sebuah Pendekatan Klinis Edisi 1, EGC, Jakarta, hal.513-30.

Marsden K. 2008. The complete book of food combining. Bandung: Qanita. p. 25-30.

Maryanto, Fatimah. 2004. Pengaruh Pemberian Jambu Biji (Psidium guajava Linn.)

Pada Lipidemia Serum Tikus (Sprague dwaley) hiperkolesterolemia. Media

Medika Indonesia. 39 : 105-11

Mayes, PA. 2003. Pengangkutan dan Penyimpanan Lipid. Biokimia Haper. Edisi 24.

Lange EGC. Halaman 260-278

Moran, R. 2011. Combretaceae : Terminalia catappa.

http://www.plantsystematics.org/imgs/robbin/r/Combretaceae_Terminalia_cat

appa_39581.html. Diakses tanggal 8 Februari 2016.

Murray RK. et.al. 2009. Harper’s Illustrated Biochemistry 28th ed. New York : Lange

Medical Publications, hlm. 155, 459

Murray, R.K., dkk. 2003. Biokimia Harper. Edisi 25. Jakarta: Penerbit Buku

Kedokteran EGC. Halaman 270

Muryati, Sri. 2009. Uji Aktivitas Antioksidan dengan Metode Linoleat-Tiosianat serta

Penentuan Kadar Fenolik dan Flavonoid Total Ekstrak Daun Ketapang

(Terminalia catappa L.). Jurnal Media Farmasi Indonesia vol 4 no 2.

Musunuru, K. 2010. Atherogenic Dyslipidemia: Cardiovascular Risk and Dietary

Intervention. Cardiovascular Research Center and Center for Human Genetic

Research. Boston. 45(10):907-914.

NCEP ATP III. 2001. ATP III Guidelines At-A-Glance Quick Desk Reference.

National Institute of Health.

Ogawa, H., Ohno, M., Baba, K., 2005. Hypotensive and Lipid Regulatory Actions Of

4 -Hydroxyderricin, A Chalcone from Angelica Keiskei, In Stroke -prone

spontaneously hypertensive rats.Clin. Exp. Pharmacol. Physiol. pp.32:19-23.

Pauly, G. 2001, “Cosmetic, Dermatological and Pharmaceutical Use of an Extract of

Terminalia catappa”, United States Patent Application.

Riskitavani, D.V., dan K.I. Purwani. 2013. Studi Potensi Bioherbisida Ekstrak Daun

Ketapang (Terminalia catappa) terhadap Gulma Rumput Teki (Cyperus

rotundus). Jurnal Sains dan Seni Pomits 2 (2): 59 – 63.

Rofida, Siti. 2015. Aktivitas Antihiperlipidemia Ekstrak Etanol Daun Annona

squamosa L. Journal of Pharmaceutical Science and Pharmacy Practice Vol 2,

Number 1.

Sastroasmoro, S dan Ismael, S. 2011. Dasar-dasar Metodologi Penelitian Klinis.

Jakarta : Binarupa Aksara, Hal 112.

Sekhon, S. 2012. Antioxidant, Anti- inflammatory and Hypolipidemic Properties of

Apple Flavonols. Nova Scotia Agricultural College Truro; Nova Scotia.

Selwyn, A.P., Braunwald E., 2005. Ischemic Heart Disease. In: Kasper, D.L., Fauci,

A.S., Longo, D.L., Braunwald, E., Hauser, S.L., Jameson, J. L., eds., Harrison’s

Principles of Internal Medicine. 16 thed. USA: McGrawHill 1434-1435

Steenis, C.G.G.J.V. 1981. Flora: Untuk sekolah di Indonesia. PT. Pradanya Paramita,

Jakarta.

Sutedjo, AY. 2008. Buku Saku. Mengenal Penyakit Melalui Hasil Pemeriksaan

Laboratorium. Penerbit Amara Books. Cetakan Ketiga, Yogyakarta. p. 85-88.

Suwandi, T., 2012. Pemberian ekstrak kelopak bunga rosela Menurunkan

malondialdehid pada tikus Yang diberi minyak jelantah. Program

Pascasarjana Universitas Udayana. Denpasar

Tapan, Erik. 2005. Kanker, Antioksidan & Terapi Komplementer. Jakarta: PT. Elex

Media Komputindo.

Thomson,L.A.J.,Evans,B.. 2006. Terminalia catappa (tropicalalmond),

ver.2.2.In:Elevitch,C.R. (Ed.), Species Proles for Pacic Island

Agroforestry. Permanent AgricultureResources (PAR), Hlualoa,

Hawaii. http://www.traditionaltree.org/. Diakses tanggal 14

Oktober 2016.

Wahjuni, S. 2011. Pemberian Minyak Ikan Lemuru (Sardinella longiceps)

sebagai anti dislipidemia melalui penigkatan HDL pada Tikus

Wistar. Jurnal Kimia 5 (2), JULI 2011. p. 156-162.

Wang, H. and R.H. Eckel. 2009. Lipoprotein lipase: From gene to obesity. Am.

J. Physiol. Endocrinol. Metab. 297:271-288.

WHO. 2013. Cardiovascular disease. Retrieved from World Health

Organization: http://www.who.int/mediacentre/factsheets/fs317/en/

Wurdianing I, Nugraheni SA, Rahfiludin Z. 2014. Efek ekstrak daun sirsak

(Annona muricata Linn) terhadap profil lipid tikus putih jantan

(Rattus Norvegicus). Jurnal Gizi Indonesia. Vol. 2, No. 3, Desember

2014: 96- 101

Yuliana, Amanda Rambu and Ardiaria, Martha. 2016. Efek Pemberian

Seduhan Kulit Buah Naga Merah (Hylocereus Polyrhizus) Terhadap

Kadar Trigliserida Tikus Sparague Dawley Dislipidemia. Thesis.

Program Studi Gizi. Universitas Diponegoro Semarang.

Yuningsih. 2012. Kercunan Sianida pada Hewan dan Upaya

Pencegahannya. Litbang Pertanian Vol I.