Pengaruh Kombinasi Interval Training Tipe Lambat dan Ekstrak Etanol Sarang Semut (Myrmecodia Pendans) terhadap Ekspresi Superoxide Dismutase, Kadar P-Selectin dan Jumlah Sel Busa pada Tikus Galur Wistar Model Diabetes Melitus Tipe-2

Abstract

Background. Macrovascular complications in diabetes mellitus (DM) are the most common cause of death in DM patients. The accumulation of free radicals induced by hyperglycemia causes endothelial dysfunction characterized by an increase in cellular adhesion molecules such as p-selectin. The condition of endothelial dysfunction causes oxidized LDL cholesterol (oxLDL) to be phagocytized by macrophages to form foam cells, which are early markers of atherosclerotic lesions. Exercise and antidiabetic drugs are an integral part of the management of DM. Interval training is one of the exercise that is often done by DM patients. Sarang semut plant (Myrmecodia pendans) is thought to have antidiabetic and antioxidant potential that is beneficial for DM patients. Aim: The purpose of this study was to analyze the effect of the combination of slow-type interval training and ethanol extract of Sarang Semut (Myrmecodia pendans) on the expression of superoxide dismutase (SOD), p-selectin levels, and the number of foam cells in Wistar strain rats type 2 diabetes mellitus (T2DM) model. Method: A total of 25 male Wistar rats were induced into a T2DM model with a high-fat diet and low-dose Streptozotocin injection. Rats were divided into 4 groups consisting of K1 (T2DM), K2 (T2DM + slow type interval training), K3 (T2DM + Sarang Semut ethanol extract), and K4 (T2DM + combination of slow type interval training and Sarang Semut ethanol extract). Slow-type interval training is done by running on a treadmill. Sarang Semut ethanol extract was given at a dose of 400mg/kg BW for 8 weeks. SOD expression was assessed by immunohistochemical staining. The level of p-selectin was measured by the ELISA method. A histopathological examination was performed with Haemotoxilin-Eosin staining to see the number of foam cells in the aorta. Ethical approval was obtained from the Health Research Ethics Committee, Faculty of Medicine, Universitas Sumatera Utara. Result: One Way ANOVA test showed that there were significant differences in SOD expression between the four groups. The post hoc test showed that the highest SOD expression was found in K4 (4.18 ± 0.41) which was significantly different from K2 (3.38 ± 0.87) and K1 (2.41 ± 0.31) (p<0.05) but not significantly different from K3 (3.67 ± 0.57 (p>0.05). The lowest p-selectin level was found in K4 [(2.61 (1.15 – 6.50)] which was different significantly from K1 [6.77 (3.88 – 31.51)] (p <0.05). There was no difference in the effect of treatment between the four groups on p-selectin levels. Kruskal Wallis test showed that there was a significant difference in the number of foam cells the between the four groups, the lowest number of foam cells was found in K4 [1.90 (1.50 – 2.10)] which was significantly different from K1 [3.30 (0.90 – 11.50)], K2 [3, 15 (1.60 – 4.40)] and K3 [2.90 (2.40 – 4.40)] (p<0.05). Conclusion: The combination of slow type interval training and ethanol extract of Sarang semut was better in increasing the expression of the antioxidant enzyme SOD and reducing the number of foam cells in the Wistar strain rat model T2DM.