DAFTAR ISI

Halaman
RINGKASAN ................................................................................................... i
KATA PENGANTAR ...................................................................................... ii
DAFTAR ISI ..................................................................................................... iv
DAFTAR TABEL ............................................................................................ vii
DAFTAR GAMBAR ........................................................................................ viii
BAB I PENDAHULUAN
1.1 Latar Belakang ..................................................................................... 1
1.2 Rumusan Masalah ................................................................................ 3
1.3 Tujuan Penelitian ................................................................................. 3
1.4 Manfaat Penelitian ............................................................................... 3
BAB II TINJAUAN PUSTAKA
2.1 Diabetes Melitus ................................................................................. 4
2.1.1 Definisi ....................................................................................... 4
2.1.2 Klasifikasi dan Etiologi .............................................................. 4
2.1.3 Patofisiologi ................................................................................ 4
2.1.4 Komplikasi ................................................................................. 7
2.1.5 Penegakan Diagnosa ....................................................................10
2.1.6 Penatalaksanaan ...........................................................................11
2.1.7 Model Tikus DM dengan Induksi HFD dan STZ ........................13
2.2 Reactive Oxygen Species (ROS) Pada DMT-2 ....................................16
2.2.1 Definisi ROS ..............................................................................16
2.2.2 Jenis ROS ...................................................................................17
2.2.3 Tahap Pembentukan ROS ...........................................................17
2.2.4 Efek ROS Terhadap Komponen Biologis Sel ............................18
2.2.5 Pembentukan ROS Pada DM .......................................................19
2.3 Antioksidan ..........................................................................................20
2.3.1 Definisi .......................................................................................20
2.3.2 Jenis dan Sumber .........................................................................20
2.3.3 Mekanisme Kerja ........................................................................22

iv
 2.4 Endotel Vaskuler .................................................................................24
2.4.1 Anatomi dan Histologi ...............................................................24
2.4.2 Fisiologi .....................................................................................25
2.5 Gangguan Fungsi Endotel Vaskuler Pada DM ....................................28
2.5.1 Kerusakan Oksidatif Sel Endotel Vaskuler ................................28
2.5.2 Mekanisme Detachment Sel Endotel ..........................................30
2.5.3 Circulating Endothelial Cells (CECs) ........................................31
2.6 Pulutan (Urena lobata) ...........................................................................32
2.6.1 Taksonomi ......................................................................................32
2.6.2 Morfologi ........................................................................................32
2.6.3 Kandungan Zat Aktif.......................................................................33
2.6.4 Efek Farmakologi ............................................................................33
BAB III KERANGKA KONSEP DAN HIPOTESIS
3.1 Kerangka Konsep Penelitian ................................................................35
3.2 Hipotesis ..............................................................................................37
3.3 Variabel Penelitian ...............................................................................37
3.4 Definisi Operasional ............................................................................37
BAB IV METODE PENELITIAN
4.1 Desain Penelitian .................................................................................38
4.2 Tempat dan Waktu Penelitian ..............................................................38
4.3 Populasi dan Sampel Penelitian ...........................................................39
4.4 Alat dan Bahan Penelitian ....................................................................39
4.4.1 Alat dan Bahan Sediaan Daun Urena lobata ..............................39
4.4.2 Alat dan Bahan Pemeliharaan Tikus ...........................................39
4.4.3 Alat dan Bahan Pembuatan Tikus Model DMT-2 ......................40
4.4.4 Alat dan Bahan Pembedahan dan Pengambilan Sampel ............40
4.4.5 Alat dan Bahan untuk Uji Pemeriksaan Marker Circulating
Endothelial Cells (CECs) ........................................................... 40
4.5 Hewan Coba .............................................................................................. 41
4.6 Ekstrak Tanaman Uji ................................................................................41
4.7 Tahapan Penelitian .................................................................................... 41
4.7.1 Proses Pembuatan Sediaan Dekok U. lobata ............................. 41
4.7.2 Proses Adaptasi Hewan Coba ..................................................... 41

v
 4.7.3 Pembuatan Tikus Model DMT-2 dengan Resistensi Insulin
Melalui Induksi HFD dan Injeksi STZ Dosis Rendah ................ 42
4.7.4 Pengelompokan Hewan Coba ..................................................... 43
4.7.5 Pembedahan Hewan Coba .......................................................... 43
4.8 Pengambilan dan Preparasi Sampel ........................................................ 44
4.9 Prosedur Pemeriksaan Marker ............................................................... 44
4.10 Teknik Analisis Data ............................................................................. 46
4.11 Diagram Alur Penelitian ........................................................................ 48
BAB V HASIL PENELITIAN
5.1 Efek Dekok Daun U. lobata Terhadap Berat Badan dan Kadar Gula ..49
5.2 Efek Dekok Daun U. lobata Terhadap Jumlah CECs .......................... 50
BAB VI PEMBAHASAN
6.1 Efek Daun U. lobata Terhadap Berat Badan dan Kadar Gula Darah ..52
6.2 Efek HFD dan STZ terhadap Jumlah Circulating Endothelial Cells
(CECs) ..................................................................................................53
6.3 Efek Dekok Daun U. lobata terhadap Jumlah CECs ..........................55
BAB VII KESIMPULAN DAN SARAN
7.1 Kesimpulan ........................................................................................59
7.2 Saran .................................................................................................59
DAFTAR PUSTAKA. .......................................................................................60
LAMPIRAN

vi
 DAFTAR TABEL

Halaman
Tabel 2.1 Klasifikasi dan Etiologi DM ........................................................... 4
Tabel 2.2 Penegakan Diagnosis Diabetes Mellitus ..........................................10
Tabel 2.3 Hubungan Prosentase A1c dengan Perkiraan Glukosa Plasma .......11
Tabel 2.4 Radikal Bebas Biologis ...................................................................17
Tabel 4.1 Tempat Penelitian ............................................................................38
Tabel 4.2 Jadwal Penelitian .............................................................................38
Tabel 4.3 Sampel Penelitian ............................................................................39
Tabel 4.4 High Fructose Diet (HFD) ..............................................................42
Tabel 4.5 Kelompok Tikus ..............................................................................43
Tabel 5.1 Data Karakteristik Sampel ...............................................................49
Tabel 5.2 Rerata Jumlah CECs Tikus ..............................................................50

vii
 DAFTAR GAMBAR

Halaman
Gambar 2.1 Patofisiologi DMT-2 ..................................................................6
Gambar 2.2 Metabolisme Fruktosa Intrahepatik .............................................16
Gambar 2.3 Potongan Melintang Pembuluh Darah ........................................25
Gambar 2.4 Protein Adhesi Endotel Junction ................................................27
Gambar 2.5 Struktur Normal dan Kerusakan Oksidatif Endotel ....................29
Gambar 2.6 Mekanisme Detachment Sel Endotel...........................................30
Gambar 2.7 Herba Pulutan (Urena lobata) .....................................................32
Gambar 5.1 Grafik Berat Badan Tikus ............................................................49
Gambar 5.2 Grafik Kadar Glukosa Darah Puasa Tikus ..................................50
Gambar 5.3 Histogram Jumlah CECs Tikus ...................................................51

viii