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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