FISIOLOGI ENDOKRIN

Dikumpulkan sebagai salah satu tugas mata kuliah Fisiologi

Dosen Pengampu:

Dr. Vita Murniati Tarawan Lubis, dr., SpOG, AIFO, M.Kes, SH

Disusun oleh:

Kelompok 2

Julia Hartati NPM 130120170002

Umar Islami NPM 130120170005

Ajeng Kartika Sari NPM 130120170008

Ivathry Rizky Octavia Putri Susilo NPM 130120170011

Faisal Kuswandani NPM 130120170014

PROGRAM STUDI ILMU KEDOKTERAN DASAR

PENDIDIKAN PASCASARJANA
FAKULTAS KEDOKTERAN
UNIVERSITAS PADJADJARAN
BANDUNG
2017
 KATA PENGANTAR

Puji syukur kami panjatkan kepada Allah SWT yang senantiasa

menganugerahkan kenikmatan iman dan islam sehingga kita dapat menghayati

karunia dan kebenaran-Nya. Karena atas rahmat dan Hidayah-Nya kami bisa

menyelesaikan makalah yang diberi judul “Fisiologi Sistem Endokrin” tepat pada

waktunya. Makalah ini kami buat untuk memenuhi tugas mata kuliah Fisiologi.

Kami menyadari bahwa dalam pembuatan makalah ini terdapat banyak

sekali kekurangan, oleh sebab itu kami mengharapkan kritik dan saran serta

masukan konstruktif dari pembaca sekalian yang dimuliakan Allah SWT.

Kami juga berharap semoga makalah ini dapat memberikan manfaat bagi

kami pada khususnya dan bagi pembaca pada umumnya.

Terima kasih.

Bandung, September 2017

Penyusun,

Kelompok 2

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 DAFTAR ISI

Kata Pengantar ........................................................................................................ii

Daftar Isi ................................................................................................................iii

Daftar Gambar ........................................................................................................ix

Daftar Tabel .........................................................................................................xiii

Bab I Pendahuluan ..................................................................................................1

Bab II Metode Penulisan .........................................................................................3

Bab III Sistem Endokrin ..........................................................................................4

3.1 Kelenjar Eksokrin Versus Endokrin ..................................................................4

3.2 Kelenjar, Hormon, dan Fungsi Hormon ............................................................5

3.3 Karakteristik Hormon dan Sintesisnya ............................................................15

3.3.1. Hormon Protein dan Polipeptida .................................................................16

3.3.2. Hormon Derivat (Turunan) Asam Amino Tirosin ......................................19

3.4 Sekresi, Transpor dan Klirens Hormon dari Darah .........................................20

3.4.1. Hormon Lokal dan Beredar .........................................................................20

3.4.2. Transpor Hormon Dalam Darah ..................................................................22

3.4.3. Klirens Hormon dari Darah .........................................................................22

3.5 Klasifikasi Hormon .........................................................................................25

3.5.1. Klasifikasi Hormon Secara Kimiawi ..........................................................25

3.6 Kontrol Umpan Balik (Feedback Control) pada Sekresi Hormon .................28

Bab IV Kelenjar Hormon dan Mekanisme Kerjanya ............................................33

4.1 Aksi Hormon ...................................................................................................33

4.2 Reseptor Hormon ............................................................................................33

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4.3 Mekanisme Kerja Hormon ..............................................................................34

Bab V Kelenjar Pituitari (Hipofisis) .....................................................................47

5.1 Suplai Darah ....................................................................................................48

5.2 Kelenjar Pituitari Anterior ...............................................................................50

5.2.1. Hormon Pertumbuhan .................................................................................52

5.2.1.1. Fungsi .......................................................................................................53

5.2.1.2. Sekresi ......................................................................................................58

5.2.2. Hormon Stimulasi Tiroid ............................................................................61

5.2.2.1. Fungsi .......................................................................................................62

5.2.2.2. Sekresi ......................................................................................................62

5.2.3. Prolaktin ......................................................................................................64

5.2.3.1. Fungsi .......................................................................................................65

5.2.3.2. Sekresi ......................................................................................................66

5.2.4. Pro-opiomelanokortin, Hormon Adrenokortikotropik, Hormon Lipotropik,

dan Hormon Stimulasi Melanosit ................................................................68

5.2.4.1. Pro-opiomelanokortin ..............................................................................69

5.2.4.2. Hormon Adrenokortikotropik ..................................................................69

5.2.4.2.1. Fungsi ....................................................................................................69

5.2.4.2.2. Sekresi ...................................................................................................70

5.2.4.3. Hormon Beta-lipotropik ...........................................................................71

5.2.4.4. Hormon Stimulasi Gama-Melanosit ........................................................72

5.2.4.5. Peptida Opioid Endogen ..........................................................................72

5.2.4.6. Regulasi Sintesis POMC ..........................................................................72

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5.2.5. Gonadotropin: Hormon Luteal (LH) dan Hormon Stimulasi Folikel (FSH)

....................................................................................................................73

5.2.5.1. Fungsi .......................................................................................................74

5.2.5.2. Sekresi ......................................................................................................75

5.2.5.3. Sekresi Episodik .......................................................................................75

5.2.5.4. Umpan Balik Positif .................................................................................76

5.2.5.5. Umpan Balik Negatif ...............................................................................76

5.3 Kelenjar Pituitari Posterior ..............................................................................77

5.3.1. Hormon Antidiuretik (ADH) dan Oksitosin ..............................................79

5.3.1.1. Hormon Antidiuretik (ADH) ....................................................................79

5.3.1.1.1. Fungsi ....................................................................................................80

5.3.1.1.2. Sintesis ..................................................................................................81

5.3.1.2. Oksitosin ..................................................................................................82

Bab VI Kelenjar Tiroid .........................................................................................85

6.1 Anatomi dan Fisiologi Kelenjar Tiroid ...........................................................85

6.2 Pembentukan, Penyimpanan dan Pelepasan Hormon Tiroid ..........................86

6.3 Aksi Hormon Tiroid ........................................................................................90

6.4 Pengaturan Sekresi Hormon Tiroid .................................................................91

Bab VII Kelenjar Adrenal .....................................................................................93

7.1 Korteks Adrenal ..............................................................................................93

7.1.1. Sintesis Hormon Korteks Adrenal ..............................................................94

7.1.2. Mineralokortikoid .......................................................................................94

7.1.3. Glukokortikoid ............................................................................................96

7.1.4. Regulasi Hormon Glukokortikoid ...............................................................97

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7.1.5. Pengaturan Hormon Glikokortikoid Kortisol ..............................................97

7.2 Androgen .........................................................................................................99

7.3 Medula Adrenal ...............................................................................................99

7.4 Sintesis dan Pelepasan Katekolamin .............................................................101

7.5 Aksi Norepinefrin dan Epinefrin ...................................................................103

Bab VIII Kelenjar Pankreas ................................................................................105

8.1 Anatomi Kelenjar Pankreas ...........................................................................105

8.1.1. Topografi ...................................................................................................105

8.1.2. Vaskularisasi .............................................................................................110

8.1.2.1. Arteri ......................................................................................................110

8.1.2.2. Vena .......................................................................................................111

8.2 Histologi Pankreas dan Hormon yang Dihasilkan ........................................111

8.2.1. Bagian Eksokrin ........................................................................................112

8.2.2. Bagian Endokrin ........................................................................................112

8.3 Insulin ............................................................................................................114

8.3.1. Struktur dan Sintesis .................................................................................114

8.3.2. Sekresi Insulin ...........................................................................................115

8.3.3. Mekanisme Aksi ........................................................................................117

8.3.4. Efek Insulin terhadap Metabolisme ..........................................................118

Bab IX Organ Reproduksi ...................................................................................120

9.1 Sistem Endokrin ............................................................................................120

9.2 Endokrin Reproduksi ....................................................................................121

9.3 Efek Klinis Opiat Endogen ...........................................................................124

9.4 Egek Klinis Neuropeptida Y .........................................................................124

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9.5 Efek Klinis Galanin .......................................................................................125

9.6 Efek Klinis Peptida Aktivasi Adenilat Siklase Pituitari ................................125

9.7 Hormon Peptida Reproduksi .........................................................................125

9.7.1. LH, FSH, dan HCG ...................................................................................125

9.7.2. Aktivin, Inhibin, dan Folistatin .................................................................127

9.8 Biosintesis dan Metabolisme Hormon Steroid ..............................................128

9.9 Testis .............................................................................................................129

9.9.1. Kontrol Humoral pada Testis ....................................................................132

9.10 Folikel Ovarium dan Korpus Luteum .........................................................135

9.10.1. Fungsi Estrogen .......................................................................................137

9.10.2. Pembagian Hormon Estrogen .................................................................139

9.10.3 Fungsi Progesteron ...................................................................................139

9.11 Hormon Antimullerian (AMH) ...................................................................140

9.11.1. Peran Hormon Antimullerian pada Folikulogengesis Ovarium ..............141

Bab X Jaringan-Jaringan Lain Penghasil Hormon ..............................................145

10.1 Jaringan Adiposa .........................................................................................145

10.2 Kelenjar Pineal ............................................................................................146

10.3 Kelenjar Paratiroid ......................................................................................147

10.4 Kelenjar Timus ............................................................................................149

10.5 Hormon di Hepar .........................................................................................149

Bab XI Pengukuran Konsentrasi Hormon ...........................................................152

11.1 Bioassay ......................................................................................................152

11.2 Radioimmunoassay .....................................................................................152

11.3 Enzyme Link Immunosourbant Assay (ELISA) ...........................................155

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Bab XII Faktor Lingkungan yang Mempengaruhi Kerja Hormon Endogen

..............................................................................................................................157

12.1 Hormon Pertumbuhan .................................................................................157

12.2 Hormon Stimulasi Tiroid ............................................................................159

12.3 Prolaktin ......................................................................................................159

12.4 Hormon Adrenokortikotropik .....................................................................160

Bab XII Simpulan ...............................................................................................162

Daftar Pustaka

viii
 DAFTAR GAMBAR

Gambar 3.1 Kelenjar Endokrin pada Wanita dan Pria.............................................7

Gambar 3.2 Skema Sintesis, Pengemasan, Penyimpanan Hingga Sekresi Hormon

Peptida dari Sel Endokrin ..................................................................18

Gambar 3.3 Perbedaan Skematik antara Hormon Beredar dan Lokal ..................21

Gambar 3.4 Hubungan antara Sekresi Hormon, Pengikatan Protein Pembawa

Hormon, dan Degradasi Hormon ......................................................25

Gambar 3.5 Rumus Molekul Berbagai Hormon Steroid .......................................26

Gambar 3.6 Sintesis Katekolamin dalam Sel Kromafin .......................................27

Gambar 3.7 Rumus Kimia Hormon Amin dan Peptida ........................................28

Gambar 3.8 Prinsip Papan Jungkat-Jungkit (Seesaw) pada Aktivitas Sistem

Endokrin ............................................................................................30

Gambar 3.9 Lengkung Umpan Balik Sederhana dan Kompleks pada Sistem
Endokrin ............................................................................................32

Gambar 4.1 Skema Masuknya Hormon ke Dalam Sel Melalui Aktivasi Protein G
............................................................................................................39

Gambar 4.2 Transduksi Sinyal Melalui Second Messenger ..................................41

Gambar 4.3 Mekanisme Kerja Hormon Larut Air ................................................44

Gambar 4.4 Mekanisme Kerja Hormon Larut Lemak ..........................................45

Gambar 5.1 Bagian Kelenjar Pituitari ...................................................................47

Gambar 5.2 Vaskularisasi Kelenjar Pituitari .........................................................49

Gambar 5.3 Hubungan Kelenjar Pituitari Anterior dengan Kelenjar Endokrin

Lainnya ..............................................................................................52

Gambar 5.4 Aksi GH yang Tidak Tergantung Somatedin ....................................57

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Gambar 5.5. Aksi GH yang Tergantung Somatedin .............................................57

Gambar 5.6 Regulasi Sekresi GH .........................................................................60

Gambar 5.7 Regulasi Sekresi TSH ........................................................................62

Gambar 5.8 Regulasi Sekresi Prolaktin ................................................................68

Gambar 5.9 Regulasi Sekresi ACTH ....................................................................68

Gambar 5.10 Regulasi Sekresi Gonadotropin .......................................................74

Gambar 5.11 Simpulan Aksi Faktor Hipotalamik Tropik .....................................77

Gambar 5.12 Kelenjar Pituitari Posterior ..............................................................78

Gambar 5.13 Produksi Pituitari Posterior .............................................................79

Gambar 5.14 Regulasi Sekresi Vasopresin ...........................................................81

Gambar 5.15 Regulasi Sekresi Oksitosin ..............................................................83

Gambar 6.1 Vaskularisasi Kelenjar Tiroid ............................................................85

Gambar 6.2 Histologi Folikel Tiroid .....................................................................86

Gambar 6.3 Iodida Transporter di Dalam sel Tiroid .............................................88

Gambar 6.4 Sintesis Hormon Tiroid .....................................................................89

Gambar 6.5 Sintesis Hormon Tiroid pada Membran Basalis ...............................89

Gambar 6.6 Mekanisme Aksi Hormon Tiroid ......................................................92

Gambar 7.1 Zona Korteks Adrenal .......................................................................93

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Gambar 7.2 Hormon Korteks Adrenal ..................................................................94

Gambar 7.3 Sintesis Hormon Kortisol ..................................................................98

Gambar 7.4 Sintesis Katekolamin .......................................................................101

Gambar 7.5 Proses Pembentukan Norepinefrin ..................................................102

Gambar 7.6 Proses Sintesis Norepinefrin ...........................................................103

Gambar 7.7 Aksi Epinefrin .................................................................................104

Gambar 7.8 Sintesis Epinefrin yang Menghasilkan Sumber Energi ..................104

Gambar 8.1 Topografi Pankreas .........................................................................106

Gambar 8.2 Bagian-Bagian Pankreas .................................................................106

Gambar 8.3 Duktus pada Pankreas .....................................................................108

Gambar 8.4 Diagram Vaskularisasi Pembuluh Darah Arteri Pankreas ..............110

Gambar 8.5 Pembuluh Darah Vena Pankreas .....................................................111

Gambar 8.6 Histologi Pankreas ...........................................................................112

Gambar 8.7 Histologi Pulau Langerhans ............................................................114

Gambar 8.8 Struktur Insulin ................................................................................115

Gambar 8.9 Sintesis Insulin ................................................................................115

Gambar 8.10 Sekresi Insulin ...............................................................................116

Gambar 8.11 Urutan Sekresi Insulin ...................................................................117

xi
Gambar 8.12 Mekanisme Aksi Insulin ................................................................118

Gambar 9.1 Umpan Balik Negatif dan Positif pada Aksis Hipotalamus-Pituitari-
Ovarium ............................................................................................122

Gambar 9.2 Alat Reproduksi Pria .......................................................................130

Gambar 9.3 Potongan Sagital Testis ...................................................................131

Gambar 9.4 Potongan Melintang Tubulus Seminiferus Testis dan Skema

Spermatogenesis ..............................................................................131

Gambar 9.5 Ekspresi AMH pada Folikel Pertama pada Preantral dan Folikel
Antral Kecil .....................................................................................144
Gambar 10.1 Kelenjar Paratiroid ........................................................................148

Gambar 11.1 Prinsip Dasar Uji Immunosorben Enzyme-linked (ELISA) untuk

Mengukur Konsentrasi Hormon ....................................................156

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 DAFTAR TABEL

Tabel 3.1 Kelenjar Endokrin dan Produk serta Fungsi Utamanya...........................8

Tabel 5.1 Ekspresi dan Regulasi Hormon Pituitari Anterior ................................50

Tabel 5.2 Efek Biologi Utama Aksis GH-IGF-1 ..................................................53

Tabel 5.3 Efek Metabolik GH dan IGF-1 secara In Vivo .....................................54

Tabel 5.4 Faktor yang Mempengaruhi Sekresi GH ..............................................58

Tabel 5.5 Faktor yang Menstimulus atau Inhibisi Sekresi GH .............................61

Tabel 5.6 Faktor yang Mempengaruhi Sekresi Prolaktin ......................................67

xiii
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