abstrak tikus wistar

iv

ABSTRAK

EFEK EKSTRAK ETANOL BUAH ALPUKAT (Persea americana Mill.)

TERHADAP PENURUNAN KADAR KOLESTEROL LDL

TIKUS WISTAR

Isabella Kurnia Tjahjono, 2015; Pembimbing I : Dr. Sugiarto Puradisastra, dr.,

M.Kes.

Pembimbing II : Adrian Suhendra., dr., Sp.PK.,

M.Kes.

Dislipidemia adalah kelainan metabolisme lipid ditandai dengan peningkatan

kadar kolesterol total, kolesterol LDL, dan trigliserida serta penurunan kadar

kolesterol HDL. Simvastatin adalah obat pilihan untuk terapi dislipidemia, tetapi

berisiko menimbulkan efek samping pada hati dan rhabdomyolysis. Masyarakat

banyak memilih terapi alternatif sebagai upaya menurunkan kadar kolesterol.

Tujuan penelitian untuk menilai efek ekstrak etanol buah alpukat (EEBA) dalam

menurunkan kadar kolesterol LDL tikus wistar dan membandingkan potensi

ekstrak etanol buah alpukat dengan simvastatin.

Penelitian bersifat ekperimental laboratorik menggunakan 30 ekor tikus Wistar

jantan yang dikelompokkan menjadi 5 kelompok (n=6), diinduksi diet tinggi

lemak (DTL). Kelompok EEBA I, EEBA II, dan EEBA III selanjutnya diberi

ekstrak etanol buah alpukat setiap hari dengan dosis 441mg/kgBB, 882mg/kgBB,

dan 1764mg/kgBB, kelompok KN (CMC 1%), dan kelompok KP

(simvastatin 0,9mg/kgBB) selama 14 hari dengan DTL tetap diberikan. Data

kadar kolesterol LDL sebelum dan sesudah induksi DTL dianalisis dengan uji t-

berpasangan, persentase penurunan kadar kolesterol LDL setelah perlakuan

dengan ANAVA satu arah, dan dilanjutkan dengan uji Tukey HSD (α=0,05).

Hasil penelitian presentase penurunan kadar kolesterol LDL didapatkan

kelompok EEBA I (12,00±2,608), EEBA II (15,50±1,527) dan EEBA III

(18,00±2,608) menunjukkan perbedaan yang sangat bermakna (p<0,01) bila

dibandingkan dengan kelompok KN (4,17±2,136). Kelompok EEBA I, EEBA II,

dan EEBA III menunjukkan perbedaan sangat bermakna dibandingkan dengan

kelompok KP (p<0,01).

Simpulan dari penelitian ini adalah ekstrak etanol buah alpukat dapat

menurunkan kadar kolesterol LDL tikus Wistar tetapi mempunyai potensi lebih

lemah dibandingkan simvastatin.

Kata kunci: alpukat, kolesterol LDL, simvastatin

Universitas Kristen Maranatha

v

ABSTRACT

THE EFFECT OF ETHANOL EXTRACT OF AVOCADO (Persea americana

Mill.) TOWARDS THE DECREASE LDL CHOLESTEROL’S LEVEL IN

WISTAR RATS

Isabella Kurnia Tjahjono, 2015; 1st

Tutor : Dr. Sugiarto Puradisastra, dr., M.Kes.

2nd

Tutor : Adrian Suhendra., dr., Sp.PK., M.Kes.

Dyslipidemia is an abnormality of lipid metabolism defined as elevated total or

LDL cholesterol’s level and triglycerides, or low HDL cholesterol’s. Simvastatin

is drug of choice for dyslipidemia, but it has hepatic side effects and

rhabdomyolysis. People choose alternative way for complementary lipid lowering.

The aim of this study is to measure the effects of ethanol extract of avocado

(EEBA) to lowering LDL cholesterol’s level of Wistar rats and to compare the

potential effect with simvastatin.

This laboratory experimental study were use 30 male Wistar rats divided into 5

groups (n=6), and given high lipid diet (DTL). Group EEBA I, EEBA II, and

EEBA III respectively given ethanol extract of avocado with dosage 441mg/kgBW,

882g/kgBW, and 1764mg/kgBW, CMC1% for KN, and simvastatin 0,9 mg/kgBW

for KP in 14 days. The data of LDL cholesterol’s level before and after DTL were analyzed with paired-t test, the percentage decreasing levels were analyzed use

one way ANOVA, followed by Tukey HSD test (α=0.05).

There were significantly decreased of percentage LDL cholesterol’s level after

treatments, group EEBA I (12.00±2.608), EEBA II (15.50±1.527), and EEBA III

(18.00±2.608), given significantly differences compared with group KN

(4.17±2.136) as negative control (p<0.01). Group I, II, and III showed significant

difference with group KP (p<0.01).

The conclusion of this research is ethanol extract of avocado (Persea

americana Mill.) decreased LDL cholesterol’s level of male Wistar rats but has

lower potency than simvastatin.

Keywords: avocado, LDL cholesterol’s, simvastatin


viii

DAFTAR ISI

JUDUL ................................................................................................................ i

LEMBAR PERSETUJUAN ............................................................................. ii

SURAT PERNYATAAN ................................................................................. iii

ABSTRAK ........................................................................................................ iv

ABSTRACT ........................................................................................................ v

KATA PENGANTAR ...................................................................................... vi

DAFTAR ISI ................................................................................................... viii

DAFTAR TABEL ........................................................................................... xii

DAFTAR GAMBAR ...................................................................................... xiii

DAFTAR LAMPIRAN .................................................................................. xiv

BAB I PENDAHULUAN

1.1 Latar Belakang ............................................................................................. 1

1.2 Identifikasi Masalah ..................................................................................... 4

1.3 Maksud dan Tujuan Penelitian ..................................................................... 4

1.4 Manfaat Karya Tulis Ilmiah ......................................................................... 5

1.4.1 Manfaat Akademis ............................................................................. 5

1.4.2 Manfaat Praktis .................................................................................. 5

1.5 Kerangka Pemikiran dan Hipotesis Penelitian ............................................. 5

1.5.1 Kerangka Pemikiran .......................................................................... 5

1.5.2 Hipotesis Penelitian ........................................................................... 6

BAB II TINJAUAN PUSTAKA

2.1 Lipid ............................................................................................................. 7

2.1.1 Klasifikasi Lipid ................................................................................ 8

2.2 Kolesterol ..................................................................................................... 8

2.2.1 Sintesis Kolesterol ............................................................................. 9

2.2.2 Transport Kolesterol ........................................................................ 10


ix

2.2.3 Ekskresi Kolesterol .......................................................................... 10

2.3 Lipoprotein ................................................................................................. 10

2.3.1 Metabolisme Lipoprotein................................................................. 13

2.3.1.1 Jalur Metabolisme Eksogen ................................................ 13

2.3.1.2 Jalur Metabolisme Endogen ................................................ 14

2.3.1.3 Jalur Reverse Cholesterol Transport ................................... 15

2.4 Dislipidemia ............................................................................................... 16

2.4.1 Klasifikasi Dislipidemia .................................................................. 16

2.4.1.1 Klasifikasi Fenotipik ........................................................... 16

2.4.1.2 Klasifikasi Patogenik .......................................................... 18

2.4.2 Faktor Risiko Dislipidemia .............................................................. 20

2.4.3 Kompikasi Dislipidemia .................................................................. 21

2.4.4 Penatalaksanaan Dislipidemia ......................................................... 22

2.4.4.1 Strategi Intervensi ............................................................... 22

2.4.4.2 Intervensi Gaya Hidup untuk Memperbaiki Profil Lipid .... 24

2.4.4.3 Terapi Farmakologi untuk Dislipidemia ............................. 26

2.5 Alpukat (Persea americana Mill.) ............................................................. 27

2.5.1 Sistematika Tumbuhan Alpukat ...................................................... 28

2.5.2 Morfologi Tumbuhan Alpukat ......................................................... 28

2.5.3 Kandungan Tanaman Alpukat ......................................................... 29

2.5.4 Efek Kandungan Buah Alpukat (Persea americana Mill.) terhadap

Kadar Kolesterol LDL ...................................................................... 30

2.5.4.1 Betasitosterol ....................................................................... 30

2.5.4.2 Lemak Tak Jenuh Tunggal Oleat (Mono Unsaturated Fatty

Acid, MUFA) dan Lemak Tak Jenuh Ganda (Poly

Unsaturated Fatty Acid) ....................................................... 31

2.5.4.3 Flavonoid ............................................................................. 32

2.5.4.4 Saponin ................................................................................ 33


x

BAB III METODOLOGI PENELITIAN

3.1 Bahan, Alat dan Subjek Penelitian ............................................................. 34

3.1.1 Alat Penelitian ................................................................................. 34

3.1.2 Bahan Penelitian .............................................................................. 35

3.1.3 Subjek penelitian ............................................................................ 35

3.2 Lokasi dan Waktu Penelitian .................................................................... 36

3.3 Metode Penelitian ...................................................................................... 36

3.3.1 Desain Penelitian ............................................................................ 36

3.3.2 Variabel Penelitian ......................................................................... 36

3.3.2.1 Definisi Konsepsional Variabel .......................................... 36

3.3.2.2 Definisi Operasional Variabel ............................................. 37

3.3.3 Perhitungan Besar Sampel .............................................................. 38

3.3.4 Prosedur Kerja ................................................................................. 39

3.3.4.1 Persiapan Bahan Uji ............................................................ 39

3.3.4.2 Pembuatan Ekstrak Etanol Buah Alpukat (EEBA) ............. 39

3.3.5 Persiapan Hewan Coba .................................................................... 40

3.4 Prosedur Penelitian .................................................................................... 40

3.4.1 Penelitian Awal ............................................................................... 40

3.4.2 Penelitian Lanjutan .......................................................................... 40

3.4.3 Prosedur Pengambilan dan Pengolahan Sampel Darah ................... 41

3.5 Metode Analisis Data ................................................................................. 42

3.6 Aspek Etik Penelitian ................................................................................ 44

BAB IV HASIL DAN PEMBAHASAN

4.1 Hasil Penelitian .......................................................................................... 45

4.1.1 Kadar Kolesterol LDL Sebelum dan Setelah Induksi DTL ............. 45

4.1.2 Kadar Kolesterol LDL Setelah Perlakuan ........................................ 46

4.2 Pengujian Hipotesis Penelitian ................................................................... 50

4.2.1 Hipotesis Penelitian I ....................................................................... 50

4.2.2 Hipotesis Penelitian II ..................................................................... 51


xi

BAB V SIMPULAN DAN SARAN

5.1 Simpulan .................................................................................................... 52

5.2 Saran ........................................................................................................... 52

DAFTAR PUSTAKA ...................................................................................... 54

LAMPIRAN ..................................................................................................... 58

RIWAYAT HIDUP ......................................................................................... 72


xii

DAFTAR TABEL

Tabel 2.1 Klasifikasi European Atherosclerosis Society (EAS) .................... 17

Tabel 2.2 Klasifikasi World Health Organization (WHO) ............................ 17

Tabel 2.3 Klasifikasi Kolesterol Total, Kolesterol LDL, Kolesterol HDL, dan

Trigliserida Menurut National Cholesterol Education Program-

Adult Treatment Panel III .............................................................. 18

Tabel 2.4 Penyakit Lain yang Dapat Menyebabkan Dislipidemia Sekunder. 19

Tabel 2.5 Faktor Risiko (Selain Kolesterol LDL) yang Menentukan Sasaran

Kolesterol LDL yang Ingin Dicapai ............................................... 20

Tabel 2.6 Tiga Kategori Risiko yang Menentukan Sasaran Kolesterol LDL

yang Ingin Dicapai ......................................................................... 21

Tabel 2.7 Strategi Intervensi Sebagai Fungsi dari Risiko Kardiovaskular

Total dan Konsentrasi Kolesterol LDL .......................................... 23

Tabel 2.8 Intervensi Gaya Hidup yang Dapat Dilakukan untuk Mengurangi

Kolesterol LDL dan Trigliserida, serta meningkatkan Kolesterol

HDL ............................................................................................... 24

Tabel 2.9 Dosis Statin Maksimal yang Direkomendasikan ............................. 26

Tabel 2.10 Kandungan Gizi di dalam 100 gram Buah Alpukat ....................... 29

Tabel 4.1 Rerata Kadar Kolesterol LDL Sebelum dan Setelah Induksi DTL 45

Tabel 4.2 Kadar Kolesterol LDL Sebelum dan Setelah Perlakuan serta Persen

Penurunannya ................................................................................ 47

Tabel 4.3 Uji Tukey HSD terhadap Persentase Penurunan Kadar Kolesterol

LDL ................................................................................................ 48


xiii

DAFTAR GAMBAR

Gambar 2.1 Low Density Lipoprotein ............................................................... 12

Gambar 2.2 Metabolisme Lipid Jalur Eksogen dan Endogen ........................... 15

Gambar 2.3 Metabolisme Lipide Jalur Reverse Cholesterol Transport ........... 16

Gambar 2.4 Buah Alpukat (Persea americana Mill.) ....................................... 27

Gambar 3.1 Alur Prosedur Penelitian ............................................................... 42


xiv

DAFTAR LAMPIRAN

Lampiran 1 Data Berat Badan Hewan Coba Setelah Induksi DTL ............... 58

Lampiran 2 Perhitungan Dosis Bahan Uji dan Pembanding.......................... 59

Lampiran 3 Kadar Kolesterol LDL Sebelum dan Setelah Induksi DTL........ 60

Lampiran 4 Hasil Uji Normalitas Shapiro-Wilk terhadap Kadar Kolesterol

LDL Sebelum dan Setelah Induks DTL .................................... 61

Lampiran 5 Hasil Uji T-Berpasangan Rerata Kadar Kolesterol LDL Sebelum

dan Setelah Induksi DTL .......................................................... 62

Lampiran 6 Uji ANAVA Satu Arah Levene Statistic Setelah Induksi DTL . 63

Lampiran 7 Hasil Uji Normalitas Shapiro-Wilk dan ANAVA Satu Arah

Levene Statistic terhadap Persentase Penurunan Kadar

Kolesterol LDL Setelah Transformasi ...................................... 64

Lampiran 8 Hasil Uji Tukey HSD Persentase Penurunan Kadar Kolesterol

LDL Setelah Transformasi ........................................................ 66

Lampiran 9 Dokumentasi ............................................................................... 68

Lampiran 10 Surat Keputusan Komisi Etik Penelitian .................................... 70

Lampiran 11 Determinasi Buah Alpukat ......................................................... 71


abstrak tikus wistar

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