TEHADAP EKSPRESI HEAT SHOCK PROTEIN 70 (HSP 70) PADA...

KARYA TULIS AKHIR

PENGARUH EKSTRAK UBI JALAR UNGU (Ipoema batatas L)

TEHADAP EKSPRESI HEAT SHOCK PROTEIN 70 (HSP 70)

PADA TIKUS JANTAN PUTIH (Rattus novergicus strain wistar)

MODEL ATEROSKLEROSIS

Oleh :

YULANDA FITRIANA

201310330311046

FAKULTAS KEDOKTERAN

UNIVERSITAS MUHAMMADIYAH MALANG

2016

HASIL PENELITIAN

PENGARUH EKSTRAK UBI JALAR UNGU (Ipoema batatas L)

TEHADAP EKSPRESI HEAT SHOCK PROTEIN 70 (HSP 70) PADA

TIKUS JANTAN PUTIH (Rattus novergicus strain wistar) MODEL

ATEROSKLEROSIS

KARYA TULIS AKHIR

Diajukan kepada

Universitas Muhammadiyah Malang untuk memenuhi

salah satu persyaratan dalam menyelesaikan

Program Sarjana Fakultas Kedokteran

Oleh :

YULANDA FITRIANA

201310330311046

UNIVERSITAS MUHAMMADIYAH MALANG

FAKULTAS KEDOKTERAN

2016

KATA PENGANTAR

Assalamu’alaikum Warahmatullah Wabarakatuh

Puji syukur ke hadirat Allah SWT atas segala rahmat dan hidayahNya

sehingga usulan penelitian yang dibuat untuk memenuhi tugas akhir sarjana

kedokteran dengan judul “PENGARUH EKSTRAK UBI JALAR UNGU

(Ipoema batatas L.) TERHADAP EKSPRESI HEAT SHOCK PROTEIN 70

(HSP 70) PADA TIKUS PUTIH JANTAN (Rattus norvegicus strain wistar)

MODEL ATEROSKLEROSIS” dapat terselesaikan.

Terima kasih saya sampaikan kepada semua pihak yang telah membantu

saya dalam menyelesaikan usulan penelitian ini, tanpa bantuan dan semangat

yang diberikan tidaklah mungkin bagi saya dapat menyelesaikan usulan

penelitian ini tepat pada waktunya.

Terima kasih kepada pembimbing saya, Dr.dr. Meddy Setiawan, Sp.PD dan

dr. Rubayat Indradi, MOH yang telah bersedia meluangkan waktunya dengan

sepenuh hati serta kesabaran dalam membimbing dan membantu saya

menyelesaikan tugas akhir ini.

Akhir kata, kritik dan saran selalu saya harapkan untuk penyempurnaan

usulan penelitian ini agar semakin baik.

Malang, 23 Desember 2016

Penulis

UCAPAN TERIMAKASIH

Allah SWT yang telah memberikan rahmat, karunia, kesehatan, dan

lindungan sehingga penulis dapat menyelesaikan tugas akhir ini

dr. Irma Suswati, M.Kes, selaku Dekan Fakultas Kedokteran Universitas

Muhammadiyah Malang atas ilmu dan bimbingannya selama di Fakultas

Kedokteran UMM.

dr. Moch. Ma’roef, Sp.OG, selaku Pembantu Dekan I Fakultas

Kedokteran UMM atas kesediaan waktu dan penyampaian ilmu yang sangat

bermanfaat bagi masa depan para mahasiswa FK UMM.

dr. Rahayu, Sp.S, selaku Pembantu dekan II Fakultas Kedokteran UMM

yang senantiasa bersabar dalam membimbing dan mengajarkan ilmunya kepada

kami.

dr. Iwan Sys Indrawanto, Sp.KJ, selaku Pembantu Dekan III, yang penuh

semangat dalam menyampaikan ilmu dan motivasi yang membangun semangat

kami selama menjalani pendidikan di Fakultas Kedokteran.

Dr, dr. Meddy Setiawan,Sp.PD, selaku pembimbing 1, atas kesabaran,

kebaikan hati, serta kesediaan dalam meluangkan waktu dalam membimbing

hingga dapat menyelesaikan penelitian ini dengan baik.

dr.Rubayat Indradi, MOH selaku pembimbing 2, atas kesabaran, kebaikan

hati, serta kesediaan dalam meluangkan waktu dalam membimbing penulis

hingga dapat menyelesaikan penelitian ini dengan baik.

dr. Indra Setiawan, Sp.THT-KL, selaku penguji tugas akhir ini, atas

segala masukan dan arahan yang sangat bermanfaat dalam pengerjaan tugas akhir

ini dan kesediaan waktu, sehingga tugas ini dapat diselesaikan dengan baik.

Orangtua saya, Bapak dan Ibu, kakak saya dr Ayyub Erdiyanto, dan

keluarga besar yang selalu memotivasi dan memberikan semangat, doa yang tak

henti-hentinya, serta dukungan moril dan materil yang tak pernah putus agar

tugas ini dapat selesai dengan baik.

Seluruh staf TU dan laboran, Mas Miftah dan Pak Joko yang bersedia

membantu setiap tahapan proses penelitian hingga penyelesaian tugas akhir ini.

Sejawat FK UMM angkatan 2013, keluarga besar Gluteus Maximus,

teman-teman kelompok skripsi ubi jalar ungu (Amira, Enggar, Fakih, Edo,

Andang) atas dukungan, bantuan, dan kerjasamanya. Semoga kelak dapat

menjadi dokter-dokter professional yang barokah, sukses dunia akhirat, dan

senantiasa dalam ketaatan kepada Allah SWT.

Sahabat-sahabatku MUNIR (Asfarina Prihandini, Prajnamita, Amira

Wahdin), Geng Syar’i, keluarga besar TBMM Nurul Qolbi, dan teman-teman kos

( Stefani, Alfien, Rossa) terimakasih banyak atas segala bantuan dan dukungan

yang diberikan

Semua pihak yang terlibat secara langsung maupun tidak langsung,

terimakasih atas bantuan dan dukungannya.

ABSTRAK

Fitriana, Yulanda. 2016. Pengaruh Ekstrak Ubi Jalar Ungu (Ipoema batatas L)

terhadap kadar Heat Shock Protein 70 (HSP 70) Tikus Putih Jantan (Rattus

norvegicus strain wistar) Model Aterosklerosis. Tugas Akhir, Fakultas

Kedokteran Universitas Muhammadiyah Malang. Pembimbing: (1) Meddy

Setiawan. (*) (2) Rubayat Indradi(**)

Latar Belakang: Penyakit jantung koroner (PJK) diawali oleh terbentuknya

aterosklerosis pada dinding vaskuler. Kolestrol menghasilkan radikal bebas yang

menginduksi Heat Shock Protein 70 ekstraseluler. Pemberian ekstrak ubi jalar

ungu diharapkan dapat menghambat radikal bebas sehingga plak aterosklerosis

tidak dapat terbentuk.

Tujuan: Mengetahui Pengaruh Pemberian Ekstrak Ubi Jalar Ungu (Ipoema

batatas L) terhadap kadar Heat Shock Protein 70 tikus jantan putih (Rattus

norvegicus strain wistar) model aterosklerosis.

Metode: True Experimental, Post Test Only Control Group Design. Ekstrak ubi

jalar ungu dosis 24 mg/hari, 48 mg/hari, 96 mg/hari diberikan selama 8 minggu

secara peroral. Analisis data menggunakan One Way ANOVA, Tukey, korelasi,

dan regresi.

Hasil penelitian dan diskusi: Ekstrak ubi jalar ungu dapat menurunkan kadar

Heat Shock Protein 70 secara bermakna dengan signifikansi 0.00 (ANOVA

p<0,05). Dosis optimal adalah 96 mg/hari. Nilai korelasi penelitian ini adalah -

0.889 yang menunjukkan terdapat hubungan signifikan, uji regresi menunjukkan

pengaruh 79%.

Kesimpulan: Ekstrak ubi jalar ungu (Ipoema batatas L.) dapat menurunkan

kadar Heat Shock Protein 70 tikus putih jantan (Rattus novergicus Strain wistar)

model aterosklerosis

Kata kunci: Aterosklerosis, Ekstrak ubi jalar ungu, Heat Shock Protein 70

*) Staf Pengajar Ilmu Penyakit Dalam Fakultas Kedokteran UMM, Spesialis

Penyakit Dalam

**) Staf Pengajar Fakultas Kedokteran UMM, Magister Kesehatan

ABSTRACT

Fitriana, Yulanda. 2016. The effect of Purple Sweet Potatoes (Ipomoea batatas

L.) Extract towards Heat Shock Protein 70 level in Atherosclerosis Model

of White Male Rats (Rattus norvegicus strain wistar). Thesis. Faculty of

Medicine, University of Muhammadiyah Malang. Advisors: (1) Meddy

Setiawan. (*) (2) Rubayat Indradi(**)

Background: Coronary heart disease (CHD) is begins by the formation of

atherosclerosis in the blood vessel walls. Cholesterol produces free radicals that

secrete extracellular Heat Shock Protein 70. With purple sweet potato extract are

expected to inhibit the free radicals, thus atherosclerotic plaques can not be

formed.

Objective: Proving that purple sweet potatoes (Ipomoea batatas L.) extract takes

effect towards Heat Shock Protein 70 level in Atheroclerosis Model of White

Male Rats (Rattus novergicus strain wistar).

Method: True Experimental, Post Test Only Control Group Design. purple sweet

potatoes extract with certain doses 24 mg/day, 48 mg/day, 96 mg/day given

orally for 8 weeks. The Data analysis used was One Way ANOVA, Tukey,

correlation, and regression.

Result: Sweet potatoes extract could decrease Heat Shock Protein 70 level

significantly with significance 0.00 (ANOVA p <0.05). Optimal dose was 96

mg/day. Correlation value was -0,889 that showed a significant correlation,

regression test showed the influence of 79%.

Conclusion: Purple sweet potatoes extract (Ipoemabatatas) takes effect to

decrease Heat Shock Protein 70 level in atherosclerosis model of white male rats

(Rattus novergicus Strain wistar).

Keywords: Atherosclerosis, Purple sweet potatoes extract, Heat Shock Protein

70

DAFTAR ISI

LEMBAR PENGESAHAN....................................................................................i

LEMBAR ORISINALITAS..................................................................................ii

LEMBAR PENGUJIAN.......................................................................................iii

KATA PENGANTAR..........................................................................................iv

UCAPAN TERIMAKASIH..................................................................................v

ABSTRAK...........................................................................................................vii

ABSTRACT..........................................................................................................viii

DAFTAR ISI.........................................................................................................ix

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

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

DAFTAR SINGKATAN.....................................................................................xiv

DAFTAR LAMPIRAN........................................................................................xvi

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 .......................................................................... 3

1.4.1 Manfaat Akademik ............................................................. 3

1.4.2 Manfaat Klinis .................................................................... 4

1.4.3 Manfaat Praktisi .................................................................. 4

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

2.1 Aterosklerosis ................................................................................. 5

2.1.1 Definisi Aterosklerosis ....................................................... 5

2.1.2 Etiologi Aterosklerosis ....................................................... 6

2.1.3 Faktor Resiko Aterosklerosis ............................................. 7

2.1.4 Klasifikasi Lesi Aterosklerosis ......................................... 11

2.1.5 Patogenesis Aterosklerosis ............................................... 14

2.2 Ubi Jalar Ungu (Ipoema batatas) ................................................. 16

2.2.1 Klasifikasi Tanaman Ubi Jalar Ungu (Ipoema batatas) ... 16

2.2.2 Morfologi Tanaman Ubi Jalar Ungu (Ipoema batatas) .... 17

2.2.3 Varietas Ubi Jalar Ungu (Ipoema batatas) ....................... 17

2.2.4 Efek dan mekanisme kerja bahan aktif ............................. 25

2.2.5 Aktifitas antioksidan antosianin ........................................ 25

2.2.6 Ascorbic acid ..................................................................... 26

2.2.7 Beta Glukan ....................................................................... 28

2.3 Metabolisme Lemak ............................................................................ 29

2.3.1 Metabolisme Lipoprotein ................................................. 32

2.3.2 LDL .................................................................................. 35

2.3.3 Kolestrol ........................................................................... 36

2.4 Pengaruh Ubi Jalar Ungu Terhadap Trigliserida .......................... 39

2.5 Heat Shock Protein ....................................................................... 43

2.5.1 Heat Shock Protein 70 ......................................................... 44

BAB 3 KERANGKA KONSEP DAN HIPOTESIS ......................................... 48

3.1 Kerangka Konsep ............................................................................ 48

3.2 Hipotesis .......................................................................................... 50

BAB 4 METODE PENELITIAN ....................................................................... 51

4.1 Rancangan Penelitian ....................................................................... 51

4.2 Tempat dan Waktu Penelitian .......................................................... 51

4.3 Populasi dan Sampel ........................................................................ 51

4.3.1 Populasi ............................................................................ 51

4.3.2 Sampel .............................................................................. 51

4.3.3 Teknik Sampling .............................................................. 51

4.3.4 Replikasi penelitian .......................................................... 52

4.3.5 Karakteristik Sampel Penelitian ....................................... 53

4.3.6 Variabel Penelitian ........................................................... 53

4.3.6.1 Variabel Bebas ...................................................... 53

4.3.6.2 Variabel Terikat ................................................... 53

4.3.7 Definisi Operasional ......................................................... 53

4.4 Alat dan Bahan Penelitian ............................................................. 54

4.4.1 Alat ................................................................................... 54

4.4.2 Bahan ................................................................................ 56

4.5 Prosedur Penelitian ....................................................................... 56

4.6 Alur Peneltian ............................................................................... 66

4.7 Analisis Data ................................................................................ 67

4.8 Jadwal Penelitian .......................................................................... 68

BAB 5 HASIL DAN ANALISIS PENELITIAN ............................................... 69

5.1 Hasil Penelitian ................................................................................ 69

5.2 Analisis Data .................................................................................... 71

5.2.1 Hasil Analisa Uji Normalitas, Homogenitas, dan One Way

Anova ....................................................................................... 71

5.2.2 Hasil Analisis Uji Korelasi ............................................... 74

5.2.3 Hasil Analisis Uji Regresi ................................................ 74

BAB 6 PEMBAHASAN ................................................................................... 78

BAB 7 KESIMPULAN DAN SARAN ............................................................. 81

DAFTAR PUSTAKA ........................................................................................... 82

LAMPIRAN ......................................................................................................... 89

DAFTAR TABEL

Tabel Halaman

Tabel 2.1............................................................................................................21

Tabel 2.2............................................................................................................21

Tabel 2.3............................................................................................................22

Tabel 2.4............................................................................................................33

Tabel 5.1............................................................................................................69

Tabel 5.2............................................................................................................70

Tabel 5.3............................................................................................................72

Tabel 5.4............................................................................................................73

DAFTAR GAMBAR

Gambar Halaman

Gambar 2.1................................................................................................6

Gambar 2.2..............................................................................................14

Gambar 2.3..............................................................................................15

Gambar 2.4..............................................................................................16

Gambar 2.5..............................................................................................18

Gambar 2.6..............................................................................................22

Gambar 2.7..............................................................................................25

Gambar 2.8..............................................................................................28

Gambar 5.1..............................................................................................70

Gambar 5.2..............................................................................................75

DAFTAR SINGKATAN

ELISA : Enzyme Lincked Immunosorbent Assay

HSP : Heat Shock Protein

LDL : Low Density Lipoprotein

NO : Nitric Oxide

NF- κβ : Nuclear Factor – kappa B

Ox-LDL : Oxidized-Low Density Lipo-protein

ROS : Reactive Oxigen Species

CPPT : The Coronary Primary Prevention Trial

HDL : High Density Lipoprotein

PJK : Penyakit Jantung Koroner

DM-tipe 2 : Diabetes Militus Tipe 2

MTFR : Metilentetrahidrofolat Reduktase

HoCys : Homosistein

RNS : Reactive Nitrogen Species

DNA : Deoxyribonucleic Acid

VLDL : Very Low Density Lipoprotein

HMG-CoA : 3-hydroxy-3-methylglutaryl

NADPH : Adenindenukleotida Phospat

ATP : Adenosin Tri Phospat

LPL : Lipoprotein lipase

FFA : Free Fatty Acid

IDL : Intermediate Density Lipoprotein

NEFA : Non Esterified Fatty Acid

SR-A : reseptor Scavenger A

LCAT : Lecithin Cholesterol Acyltransferase

CETP : Cholesterol Ester Transfer Protein

AMPK : Adenosine Monophosphate Activated Protein Kinase

TAG : Triasigliserol

DAG : Diasilgliserol

MAG : Monoasilgliserol

SR-B1 : Scavenger Reseptor Class B type 1

HSR : Heat Shock Response

sHsp : small heat shock protein

TNF-α : Tumor Necrosis Factor α

DAFTAR LAMPIRAN

Lampiran Halaman

1. Data penelitian 89

2. Lembar hasil analisis 90

3. Dokumentasi Penelitian 95

4. Determinasi Tanaman Ubi Jalar Ungu 98

5. Surat Etik Penelitian 99

6. Surat Keterangan Penelitian 100

7. Lembar Konsultasi Tuga Akhir 101

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