PERBEDAAN KADAR HIGH DENSITY LIPOPROTEIN (HDL) PADA
TIKUS PUTIH JANTAN (Rattus norvegicus) Galur Wistar YANG
DIBERI HIGH FAT DIET DENGAN PEMBERIAN PERASAN LEMON
FINO (Citrus limon fino) DAN JERUK NIPIS (Citrus aurantifolia)
TUGAS AKHIR
Untuk Memenuhi Persyaratan
Memperoleh Gelar Sarjana Gizi
Oleh:
Nadia Magdalena
NIM 135070300111042
PROGRAM STUDI ILMU GIZI
FAKULTAS KEDOKTERAN
UNIVERSITAS BRAWIJAYA
MALANG
2017
DAFTAR ISI
Halaman
Judul ............................................................................................................ i
Halaman Pengesahan ................................................................................. ii
Pernyataan Keaslian Tulisan ....................................................................... iii
Kata Pengantar ............................................................................................ iv
Abstrak ........................................................................................................ vi
Daftar Isi ...................................................................................................... viii
Daftar Gambar ............................................................................................. xii
Daftar Tabel ................................................................................................. xiii
Daftar Singkatan .......................................................................................... xiv
BAB I PENDAHULUAN
1.1 Latar Belakang Masalah .................................................................... 1
1.2 Rumusan Masalah ............................................................................ 4
1.3 Tujuan Penelitian ............................................................................... 4
1.3.1 Tujuan Umum ........................................................................ 4
1.3.2 Tujuan Khusus ....................................................................... 5
1.4 Manfaat Penelitian ............................................................................. 5
1.4.1 Manfaat Akademik ................................................................. 5
1.4.2 Manfaat Praktis ...................................................................... 5
BAB II TINJAUAN PUSTAKA
2.1 Lemak ............................................................................................... 6
2.1.1 Definisi lemak ........................................................................ 6
2.1.2 Klasifikasi lemak .................................................................... 6
2.1.3 Definisi lipoprotein .................................................................. 7
2.1.4 Klasifikasi lipoprotein.............................................................. 7
2.1.5 Metabolisme Lemak ............................................................... 10
2.1.6 Metabolisme lipoprotein ......................................................... 11
2.2 Dislipidemia ....................................................................................... 14
2.2.1 Definisi Dislipidemia ............................................................... 14
2.2.2 Prevalensi Dislipidemia .......................................................... 15
2.2.3 Etiologi Dislipidemia ............................................................... 16
2.2.4 Patofisiologi Dislipidemia ....................................................... 17
2.2.5 Manifestasi Dislipidemia ......................................................... 18
2.2.6 Terapi Dislipidemia ................................................................ 18
2.3 Lemon ............................................................................................... 19
2.3.1 Taksonomi Lemon (Citrus limon fino) ..................................... 19
2.3.2 Definisi dan Ciri-Ciri Lemon.................................................... 19
2.3.3 Kandungan Lemon ................................................................. 23
2.3.4 Pengaruh Lemon terhadap Profil Lipid ................................... 25
2.4 Jeruk Nipis ........................................................................................ 27
2.4.1 Taksonomi Jeruk Nipis (Citrus aurantifolia) ............................ 27
2.4.2 Definisi dan Ciri-Ciri Jeruk Nipis ............................................. 27
2.4.3 Kandungan Jeruk Nipis .......................................................... 28
2.4.4 Pengaruh Jeruk Nipis terhadap Profil Lipid ............................ 29
BAB III KERANGKA KONSEP DAN HIPOTESIS
3.1 Kerangka Konsep Penelitian ............................................................. 32
3.2 Penjelasan Kerangka Konsep Penelitian ........................................... 33
3.3 Hipotesis ........................................................................................... 35
BAB IV METODOLOGI PENELITIAN
4.1 Rancangan Penelitian ....................................................................... 36
4.2 Populasi dan Sampel......................................................................... 37
4.2.1 Subjek Penelitian ................................................................... 37
4.2.2 Kriteria Inklusi ........................................................................ 37
4.2.3 Kriteria Eksklusi ..................................................................... 38
4.2.4 Drop out ................................................................................. 38
4.2.5 Perhitungan Sampel .............................................................. 38
4.2.6 Randomisasi Sampel ............................................................. 39
4.2.7 Penentuan Perlakuan............................................................. 42
4.3 Variabel Penelitian ............................................................................ 43
4.3.1 Variabel Bebas....................................................................... 43
4.3.2 Variabel Terikat ...................................................................... 43
4.3.3 Variabel Terkendali ................................................................ 43
4.4 Lokasi dan Waktu Penelitian ............................................................. 43
4.4.1 Lokasi Penelitian .................................................................... 43
4.4.2 Waktu Penelitian .................................................................... 43
4.5 Bahan dan Alat/Instrumen Penelitian ................................................. 44
4.5.1 Alat Penelitian ........................................................................ 44
4.5.2 Bahan Penelitian .................................................................... 45
4.5.2.1 Bahan Pakan Tikus .................................................. 45
4.5.2.2 Bahan Bius Tikus ..................................................... 46
4.5.2.3 Bahan Pemeriksaan HDL ......................................... 46
4.6 Definisi Operasional .......................................................................... 47
4.7 Prosedur Penelitian dan Pengumpulan Data ..................................... 48
4.7.1 Perlakuan pada Tikus Percobaan .......................................... 48
4.7.2 Pembuatan Pakan Standar .................................................... 50
4.7.3 Pembuatan Perasan Lemon dan Cara Pemberian ................. 51
4.7.4 Pembuatan Perasan Jeruk Nipis dan Cara Pemberian .......... 51
4.7.5 Penentuan Volume Pemberian Lemon dan Jeruk Nipis ......... 51
4.7.5.1 Volume Pemberian Perasan Lemon (Citrus limon fino)
................................................................................. 52
4.7.5.2 Volume Pemberian Perasan Jeruk Nipis (Citrus
aurantifolia) .............................................................. 52
4.7.6 Pembuatan Suspensi Simvastatin .......................................... 52
4.7.7 Penentuan Dosis Simvastatin ................................................ 53
4.7.8 Proses Pembuatan dan Cara Pemberian Pakan Tinggi
Lemak (High Fat Diet) pada Tikus Wistar ............................... 53
4.7.9 Pemeriksaan Kadar High Density Lipoprotein (HDL) .............. 54
4.8 Analisis Data ..................................................................................... 55
BAB V HASIL PENELITIAN DAN ANALISIS DATA
5.1 Karakteristik Sampel ......................................................................... 57
5.2 Perubahan Berat Badan Tikus ........................................................... 68
5.3 Asupan Pakan Tikus ......................................................................... 61
5.3.1 Jumlah Asupan Pakan Tikus .................................................. 61
5.3.2 Jumlah Asupan Energi Tikus Selama Penelitian .................... 62
5.3.3 Jumlah Asupan Lemak Tikus Selama Penelitian .................... 63
5.3.4 Jumlah Asupan Protein Tikus Selama Penelitian ................... 64
5.3.5 Jumlah Asupan Karbohidrat Tikus Selama Penelitian ............ 65
5.4 Kadar High Density Lipoprotein Tikus Selama Penelitian .................. 67
BAB VI PEMBAHASAN
6.1 Karakteristik Subjek Penelitian .......................................................... 69
6.2 Perubahan Berat Badan Tikus ........................................................... 70
6.3 Asupan Energi, Lemak, Protein, dan Karbohidrat Antar Kelompok
Perlakuan .......................................................................................... 72
6.4 Kadar Kadar High Density Lipoprotein (HDL) Tikus Selama
Penelitian .......................................................................................... 72
6.4 Keterbatasan Penelitian .................................................................... 77
BAB VII PENUTUP
7.1 Kesimpulan ....................................................................................... 79
7.2 Saran ................................................................................................ 79
DAFTAR PUSTAKA ..................................................................................... 80
Lampiran 1. Randomisasi Tikus Percobaan ............................................... 89
Lampiran 2. Diagram Alur Pembuatan Perasan Lemon dan Jeruk Nipis .... 91
Lampiran 3. Diagram Alur Pembuatan Larutan Simvastatin ....................... 92
Lampiran 4. Diagram Alur Pembuatan Pakan Diet Normal ........................ 93
Lampiran 5. Diagram Alur Pembuatan Pakan Diet Tinggi Lemak (High Fat
Diet) ....................................................................................... 94
Lampiran 6. Komposisi Bahan dan Energi Pakan Diet Normal .................. 95
Lampiran 7. Komposisi Bahan dan Energi Pakan Diet Tinggi Lemak (High
Fat Diet) ................................................................................. 96
Lampiran 8. Hasil Analisis Statistik ............................................................ 97
Lampiran 9. Prosedur Pemeriksaan Kadar HDL ........................................ 103
Lampiran 10. Tabel Konversi Perhitungan Dosis ......................................... 104
Lampiran 11. Dokumentasi Perawatan Hewan Coba ................................... 105
Lampiran 12. Master Data ........................................................................... 107
Lampiran 13. Kelayakan Etik ...................................................................... 115
DAFTAR GAMBAR
Halaman
Gambar 2.1 Metabolisme Lemak .............................................................. 11
Gambar 2.2 Jalur Metabolisme Lipoprotein Endogen Dan Eksogen ......... 14
Gambar 2.3 Lemon Eureka ....................................................................... 21
Gambar 2.4 Lemon Lisbon ....................................................................... 21
Gambar 2.5 Lemon Meyer ........................................................................ 22
Gambar 2.6 (a) Lemon Fino Belum Matang .............................................. 23
(b) Lemon Fino Sudah matang .............................................. 23
(c) Penampakan Vertikal Lemon Fino ................................... 23
(d) Penampakan Horizontal Lemon Fino ............................... 23
Gambar 2.7 Jeruk Nipis ............................................................................ 28
Gambar 4.1 Pembagian Kelompok Perlakuan ........................................... 36
Gambar 4.2 Desain Lay Out Rancangan Acak Lengkap Percobaan ......... 41
Gambar 5.1 Rata-Rata Peningkatan Berat Badan Tikus (gram) ............... 59
Gambar 5.2 Rata-Rata Asupan Pakan (gram) .......................................... 61
Gambar 5.3 Rata-Rata Asupan Energi (kkal) ............................................ 62
Gambar 5.4 Rata-Rata Asupan Lemak (gram) .......................................... 63
Gambar 5.5 Rata-Rata Asupan Protein (gram) ......................................... 64
Gambar 5.6 Rata-Rata Asupan Karbohidrat (gram) .................................. 65
Gambar 5.7 Rata-Rata Kadar HDL (mg/dl) ............................................... 67
DAFTAR TABEL
Halaman
Tabel 2.1 Komposisi Lipoprotein ........................................................... 8
Tabel 2.2 Kadar Profil Lipid ................................................................... 10
Tabel 2.3 Perbedaan Kandungan Zat Gizi Lemon dan Jeruk Nipis ....... 29
Tabel 4.1 Pengulangan Perlakuan ........................................................ 37
Tabel 4.2 Pangkat atau Ranking dari 40 Angka Acak ........................... 40
Tabel 4.3 Volume Pemberian Perasan Buah Lemon (Citrus limon fino) 52
Tabel 4.4 Volume Pemberian Perasan Jeruk Nipis (Citrus aurantifolia) 52
Tabel 4.5 Komposisi Pakan Tinggi Lemak (High Fat Diet) .................... 54
Tabel 5.1 Karakteristik Sampel ............................................................. 57
Tabel 5.2 Peningkatan Berat Badan Tikus (gram) ................................. 58
Tabel 5.3 Kadar HDL Pre-Test dan Post-Test (mg/dl) ........................... 68
DAFTAR SINGKATAN
ACAT : Cholesterol acyltransferase
APO B : Apolipoprotein B
EDTA : Ethylenediaminetetraacetic Acid
HDL : High Density Lipoprotein
HFD : High Fat Diet
HMG Co-A : 3-hydroxy-3-methylglutaryl Coenzim A
HOMA-IR : Homeostatic Model Assesment for Insulin Resistance
IDL : Intermediate Density Lipoprotein
LDL : Low Density Lipoprotein
MTP : Microsomal Transfer Protein
NADPH : Nicotinamide Adenine Dinucleotide Phosphate
PCSK9 : Proprotein Convertase Subtilisin/Kexin Type 9
PKV : Penyakit Kardiovaskuler
TG : Trigliserida
TLC : Therapeutic Lifestyle Change
VLDL : Very Low Density Lipoprotein
i
ABSTRAK
Magdalena, Nadia. 2017. Perbedaan Kadar High Density Lipoprotein (HDL) pada Tikus Putih Jantan (Rattus norvegicus) Galur Wistar yang Diberi High Fat Diet dengan Pemberian Perasan Lemon Fino (Citrus limon fino) dan Jeruk Nipis (Citrus aurantifolia). Tugas Akhir, Program Studi Ilmu Gizi, Fakultas Kedokteran Universitas Brawijaya. Pembimbing : (1) Dr. dr. Nurdiana, M.Kes., (2) Olivia Anggraeny, S.Gz., M.Biomed
Pola makan yang mengandung makanan yang tinggi lemak dapat memicu terjadinya dislipidemia. Terapi non-farmakologi yang sering digunakan untuk mengatasi dislipidemia adalah dengan mengonsumsi perasan lemon. Alternatif lain adalah jeruk nipis yang harganya lebih murah dan mudah didapatkan. Penelitian ini bertujuan untuk mengetahui adanya perbedaan pada kadar HDL tikus yang diberi high fat diet dengan pemberian perasan lemon dan jeruk nipis. Penelitian ini menggunakan 32 ekor tikus putih galur wistar jantan yang terbagi menjadi 8 kelompok perlakuan, yaitu kelompok dengan pemberian high fat diet, kelompok dengan pemberian high fat diet dan simvastatin, kelompok dengan pemberian high fat diet dan perasan lemon fino, dan kelompok dengan pemberian high fat diet dan perasan jeruk nipis dengan volume pemberian 1 ml/ekor/hari, 2 ml/ekor/hari, dan 3 ml/ekor/hari. Statin, perasan lemon dan jeruk nipis diberikan melalui sonde selama 5 minggu. Kadar HDL diukur menggunakan alat Lipid Pro Lipid Profile Test Strips. Hasil penelitian menunjukkan bahwa tidak terdapat perbedaan kadar HDL antar kelompok perlakuan (p=0,400). Kesimpulan dari penelitian ini adalah tidak terdapat perbedaan kadar HDL pada kelompok yang diberikan perasan lemon maupun jeruk nipis. Kata kunci: HDL, simvastatin, lemon, jeruk nipis
2
ABSTRACT
Magdalena, Nadia 2017. Difference in High Density Lipoprotein (HDL) Levels in Male Rat (Rattus norvegicus) Wistar Strains Given High Fat Diet with Lemon Fino Juice (Citrus limon fino) and Lime Juice (Citrus aurantifolia). Final Assignment, Science of Nutritition Study Program, Faculty of Medical, University of Brawijaya. Guidance of (1) Dr. Dr. Nurdiana M.Kes, (2) Olivia Anggraeny, S.Gz, M.Biomed
Dietary habit contains high fat food can trigger the occurrence of
dyslipidemia. Non-pharmacological therapy that often used to treat dyslipidemia is by consuming lemon juice. Another alternative is the lime which is cheaper and easier to obtain. This study aims to determine the HDL levels of rats given high fat diet with lemon juice and lime juice. This research used 32 male rats which were divided into 8 group of treatment; treatment group that was given high fat diet, treatment group that was given high fat diet and simvastatin, treatment group was given high fat diet and lemon juice and treatment group which was given high fat diet and lime juice with 1ml/rat/day, 2 ml/rat/day, and 3 ml, rat/day given volume. Statin, lemon juice and lime juice are given through sonde for 5 weeks. HDL level after the treatment are measured using Lipid Pro Profile Test Strips. The result shows that there is no difference of HDL levels among treatment groups (p=0,400). The conclusion from this research is there is no difference of HDL levels in the group given lemon juice or lime juice.
Keyword: HDL, simvastatin, lemon, lime