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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
Daftar Pustaka
Adam, Jhon MF 2006, Dislipidemia Dalam: Sudoyo WA, Setiyohadi B,
Alwi I, Simadibrata M, Setiati S (eds). Buku Ajar Ilmu Penyakit
Dalam, 5th
edn, jilid III, FK UI, Jakarta, hal 1984-1992.
Adewole SO, Ojewole JAO, 2009, Protective Effects of Annona Muricata
Linn. (Annonaceae) Leaf Aqueous Extract on Serum Lipid Profiles
and Oxidative Stress in Hepatocytes of Streptozotocin-Treated
Diabetic Rats, Department of Pharmacology School of Pharmacy
& Pharmacology Faculty of Health Sciences, University of
KwaZulu-Datal.South Africa.
Andriani, Yosie, 2007, Uji Aktivitas Antioksidan Ekstrak Betaglukan Dari
Saccharomyces Cerevisiae, Jurnal Gradien Vol. 3, No. 1, pp: 226-
230.
Astuti, S, 2008, Isoflavon Kedelai dan Potensinya Sebagai Penangkap
Radikal Bebas, Jurnal Teknologi Industri dan Hasil Pertanian, Vo.
13, No. 2, pp: 126-136.
Basu S, Binder RJ, Suto R, Anderson KM, Srivastava PK, 2000, Necrotic
But Not Apoptotic cell Death Releases Heat Shock Proteins Which
Deliver a Partial Maturation Signal to Dendritic cells and Activate
The NF-kappa B Pathway, Int Immuno, Vol 12, pp.1539–1546.
Bengmark, S, 2007, Advanced Glycation and Lipoxidation End Products
– Amplifiers of Inflammation : The Role of Food. In : Journal of
Parenteral and Enteral Nutrition, Volume 31, No. 5, 2007 : pp.
430-440.
Brown L, Johnson J, Majumdar S, et al, 2005, Evidence of Suboptimal
Management of Cardiovaskular Risk in Patients With Type 2
Diabetes Mellitus and Symptomatic Atherosclerosis, CMAJ, Vol
171, pp. 1189-92.
Collins, Tucker., Cybulsky, Myron I, 2001, NF-ÊB : Pitoval Mediator Or
Innocent Bystander In Atherogenesis?, The Jounal Of Clinical
Investigation, Volume 107, Number 3, pp.255-263.
De Maio Antonio, Vazquez Daniel, 2013, Extracellular heat shock
proteins: a new location, a new function, Center for Investigations
of Health and Education Disparities, School of Medicine
University of California San Diego, La Jolla, California. Vol 4, pp.
239–246.
Emily Ho, 2002, NFκB – What is it and What’s the deal with radicals?,
Linus Pauling Institute Scientist Department of Nutrition and Food
Management, Oregon State University.
Enzo, 2010, Heat Shock Proteins & the Cellular Stress Response, Life
Sciences.
Felix F.W, Lucyana A.S, Sarwono W, 2009, Peran Heat Shock Protein
terhadap Resistensi Insulin, Fakultas Kedokteran Universitas
Indonesia, Jakarta.
Ginting E, Utomo JS, Yulifianti R, et al, 2011, Potensi Ubi Jalar Ungu
sebagai Pangan Fungsional, Iptek Tanaman Pangan, vol 6, no 1,
pp. 116-138.
Hasyim A, Yusuf M, 2007, Ubi Jalar Kaya Antosianin Pilihan Pangan
Sehat, Balai Penelitian Tanaman Kacang-kacangan dan Umbi-
umbian, viewed 25 Januari 2015,
http://pangan.litbang.deptan.go.id/d/h.
Himaku, 2014, Ubi Jalar Ungu (Ipoema batatas L ), Pencegahan
Aterosklerosis, FK UNDIP, Semarang.
Hou DX, 2004, Molecular Mechanism Behind The Chemopreventive
Effect of Anthocyanidins, Journal of Biomedicine and
Biotechnology, vol. 5.
Hunter, Lavin, 2004, Roles Of Extracelular Heat Shock Proteins : A New
Sense Of Danger, Chester For Stress Reasearch, Department Of
Biological Sciences, University Of Chester.
Husna N, Novita M, Rohaya S, 2013, Kandungan Antosianin dan
Aktivitas Antioksidan Ubi Jalar Ungu Segar dan Produk
Olahannya, Agritech, Vol 33, No. 3, pp. 296-302.
Hwang, YP, Choi, JH, Yun, HJ, Han, EH, 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 iNOS Expression, Food and
Chemical Toxicology, vol 49.
Jamie , et al, 2000, Hypothesis : A Central Role For The Endothelial
NADPH Oxidase In Atherosclerosis, FEBS, Pubmed, volume 472,
No 1, pp 1-4.
Jana Tkáčová, Mária A, 2012, Heat Shock Proteins (HSPs): a Review.
Slovak University of Agriculture in Nitra, Faculty of
Biotechnology and Food Sciences, Department of Food Hygiene
and Safety, 949 76-Nitra, Tr. A. Hlink,u 2, Slovakia. Scientific
Papers: Animal Science and Biotechnologies, 2012, 45.
Japardi, 2002, Patofisiologi Stroke Infark Akibat Tromboemboli, viewed
20 Maret 2016, Dari: http://www.library.usu.ac.i
Jawi IM, Suprapta DN, Sutiryasa IWP, 2007, Efek Antioksidan Ekstrak
Umbi Ubi Jalar Ungu (Ipomoiea batatas L.) Terhadap Hati
Setelah Aktivitas Fisik Maksimal dengan Melihat Kadar AST dan
ALT Darah pada Mencit, Dexa Medica, vol. 3, No. 20.
Jing P, 2006, Purple Corn Anthocyanins: Chemical Structure,
Chemopreventive Activity and Structure/ Function Relationships,
PhD thesis, Ohio State University, Ohio.
Kahkonen MP, Heinoren M, 2003, Antioxidant Activity of Anthocyanins
and Their Aglycons, J Agric Food Chem, vol. 51.
Karlsen A, Retterstol L, Laake P, et al, 2007, Anthocyanins Inhibit
Nuclear Factor-KB Activation in Monocytes and Reduce Plasma
Concentration of Pro-Inflammatory Mediators in Healthy Adults.
In : The Journal of Nutrition, Vol. 137, 2007 : pp 1951-1954.
Kim Y, Wampler DJ, 2009, Anthocyanin Content in Various Anthocyanin
Rich Fruits and Vegetables, Sensus Technical Note, Hamilton.
Lusis A, 2000, Atherosklerosis, National Institute of Health, 407 (6801),
pp. 23-24.
Marks Allan D, Marks Collen M, Smith, 2012, Biokimia Kedokteran
Dasar, Dalam: Metabolisme Lemak, Jakarta, EGC, Hal. 478 – 533.
Mayes PA, 2003, Sintesis, Pengangkutan, dan Ekskresi Kolesterol,
Dalam: : Murray RK, Granner DK, Mayes PA, Rodwell VW
(eds). Biokimia Harper, 25th
edn, EGC, Jakarta , Hal . 270-271.
Mayes PA, 2003, Karbohidrat yang Memiliki Makna Fisiologis, Dalam :
Murray RK, Granner DK, Mayes PA, Rodwell VW (eds).
Biokimia Harper, 25th
edn, EGC, Jakarta , Hal. 143-145.
Mayes PA, 2003, Pengangkutan dan Penyimpanan Lipid, Dalam: Murray
RK, Granner DK, Mayes PA, Rodwell VW (eds). Biokimia
Harper, 25th
edn, EGC, Jakarta , Hal. 254-269.
Mayes PA, 2003, Struktur dan Fungsi Vitamin Larut-Air, Dalam: Murray
RK, Granner DK, Mayes PA, Rodwell VW (eds). Biokimia
Harper, 25th
edn, EGC, Jakarta , Hal. 609-611.
Mayes PA, 2003, Struktur dan Fungsi Vitamin Larut-Lipid, Dalam:
Murray RK, Granner DK, Mayes PA, Rodwell VW (eds).
Biokimia Harper, 25th
edn, EGC, Jakarta , Hal. 620.
Murray RK, Bender DA, Botham KM., et al, 2009, Harper’s illustrated
biochemistry. 28th ed. The McGraw-Hill Companies, Inc, New
York.
Nickel W, Seedorf M, 2008, Unconventional mechanisms of protein
transport to the cell surface of eukaryotic cells. Ann Rev Cell Dev
Biol, Vol 24, pp.287–308. [PubMed: 18590485]
Pockley AG, Muthana M, Calderwood SK, 2008, The Dual
Immunoregulatory Roles of Stress Proteins, Trends Biochem Sci
Vol 33, pp.71–79.
Pudji RA, 2014, Pencegahan dan Penatalaksanaan Aterosklerosis, Buku
Ajar Ilmu Penyakit Dalam. Jakarta.
Qin Y, Xia M, Ma J, et al, 2009, Anthocyanin Supplementation Improves
Serum LDL- and HDL-Cholesterol Concentrations Associated
with The Inhibition of Cholesteryl Ester Transfer Protein in
Dislipidemic Subject, Am J Clin Nutr, pp. 5-8.
Qingbo Xu, 2002, Smooth Muscle Cells in Transplant Atherosclerotic
Lesions Are Originated From Recipients, but Not Bone Marrow
Progenitor Cells, American Heart Association
Ranzio B, 2002, Anti Inflamatory Activities Of Polyphenol-Review :
Polyphenol As Anti Inflamatory Agent, Journal Of Naturopathic
Medicine, Volume 9, p.44-50.
Rahman A, 2012, Faktor-Faktor Risiko Mayor Aterosklerosis Pada
Berbagai Penyakit Aterosklerosis di RSUP. DR. Kariadi
Semarang, Media Medika Muda.
Rakhmiditya H, Kartini A, 2014, Pengaruh Pemberian Snack Bar
Berbahan Dasar Kombinasi Ubi Jalar Ungu dan Kedelah Hitam
dan Kuning Terhadap Kadar Trigliserida Pada Wanita Dewasa
Hipertrigliserida, Journal of Nutrition College, Vol 3, No. 1, pp.
106-116.
Silbernagl S, 2006, Teks dan Atlas Berwarna Patofisiologi, EGC, Jakarta.
Suda I, Oki T, Masuda M, 2003, Physiological Functionality of Purple-
Fleshed Sweet Potatoes Containing Anthocyanins and Their
Utilization in Foods, JARQ, 37, pp. 167-173.
Sumiati, 2010, Penanganan Stress Pada Penyakit Jantung Koroner, CV
trans Info Medika, Jakarta.
Tkáčová J, Angelovičová M, 2012, Heat Shock Proteins (HSPs), Animal
Science and Biotechnologies, Vol 1,pp. 45, Slovakia.
Tsuda T, 2000, The Role of Anthocyanins As An Antioxidant Under
Oxidative Stress In Rats, Biofactors, vol. 13.
Wang J, Bennett M, 2012, Aging and Atherosclerosis, American Heart
Association, Vol 111, viewed 23 Maret 2016,
Dari: < http:// circres.ahajournals.org/content//111/2/24.long>
Widowati, Sarbini, 2010, Efek Penghambatan Bunga Rosella Merah (
Hibiscus sabdariffa Linn) Sebagai Anti Aterosklerosis Terhadap
Aktivasi NF-κβ Pada Kultur Sel Endotel Yang Dipapar Low
Density Lipoprotein Teroksidasi. Jurusan Gizi Fakultas Ilmu
Kesehatan, Universitas Muhammadiyah Surakarta.
Wilson HM, Chettibi S, Jobin C, et al, 2005, Inhibition of Macrophage
Nuclear Factor-KappaB Leads to a Dominant Anti Inflammatory
Phenotype That Attenuates Glomerular Inflammation In Vivo,
American Journal of Pathologi, Vol 167, No. 1, pp. 27-37.
World Health Organization, 2009, World Health Statistics, France.
Yong PL, Jae HC, Eun HH, et al, 2011, Purple Sweet Potato
Anthocyanins Attenuate Hepatic Lipid Accumulation, Through
Activating Adenosin Monophosphat-Activated Protein Kinase in
Human HpG2 Cell and Obese Mice, NR journal, 31, pp 896-906.
Zhao CL, Guo HC, Dong ZY, 2009, Pharmacological and nutritional
activities of potato anthocyanins, African Journal of Pharmacy
and Pharmacology, vol. 2.