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KERSEN LEAF TEA’S EFFECTS ON MALE MICE’S LIVER AND

KIDNEY FUNCTIONS INDUCED BY ALLOXAN

Wiyadi

, Mustaming

, Rus Andraini

Department of Nursing, Politeknik Kesehatan Kalimantan Timur, Samarinda, East Kalimantan, Indonesia

Department of Laboratory Engineering, Politeknik Kesehatan Kalimantan Timur, Samarinda, East Kalimantan,

Indonesia

wiyadi1968@gmail.com

ARTICLE INFO

ABSTRACT

Published: December 11

2022

Kersen leaf is a tree native to Southern America and Southern Mexico. In

Indonesia, this tree is very easy to get because it grows a lot on the side of

the streets. Empirically, Kersen leaves have been widely used by the public

as one of the herbs or herbs to overcome various diseases, including DM

disease. The study used True Experimental design with Pre and post Control

Design design. The purpose of this study was to test the effect of using

Kersen Leaf Tea on Hepar and Kidney function. Hepar function will be

measured by assessing levels of Alanain Transminerase (ALT) Aspartate

aminotransferases (AST). For kidney function is assessed by measuring

Creatinine and Ureum levels. The results of the Shapiro test normality test

obtained data that were not normally distributed so that the Bivariate test

used alternative tests, namely the Kruscal Walis test and the Wilcoxon Test.

The results of the study on the administration of kersen leaf tea there were

differences between the Control group with the dose group of 2%, dose 4%

and dose 6% at ALT levels (p = 0.000), AST levels (p = 0.005), and

creatinine levels (p = 0.007) but there was no difference in Urium (P =

0.447). The results of the Wilcoxon test showed the effect of giving kersen

leaf tea on ALT levels ( p = 0.018), AST levels (p = 0.000), Urium levels (p

= 0.37) and creatinine levels (p = 0.038). The administration of kersen leaf

tea improves liver and kidney function in Alloxan-induced male mice.

Keywords: kersen leaf tea, liver

function, kidney function

This work is licensed under CC

BY-SA 4.0

INTRODUCTION

Diabetes Mellitus is one of the non-communicable diseases with a prevalence of 9.3% or

equivalent to 463 million people aged 20-79 years in 2019 and Indonesia ranks 8

with 10.7

million sufferers and increases to 5th place with 19.47 million sufferers in 2021 (Ministry of Health

RI, 2020) (IDF, 2021). Based on Riskesdas in 2018 East Kalimantan ranks second after DKI

Jakarta with a prevalence of 3.1% (Ministry of Health RI, 2020). It shows that DM sufferers

experience a significant increase every year (IDF, 2021). The increase in the prevalence of DM

especially in developing countries follows patterns of urbanization and lifestyle changes including

western-style diets related to obesity or better survival (Forbes & Cooper, 2013; Saeedi et al.,

2019). This shows that environmental factors also contribute to this disease in addition to genetic

factors (Forbes & Cooper, 2013).

DM disease is a disorder of carbohydrate, lipid and protein metabolism caused by damage to

pancreas cells as insulin products as a result of experiencing insulin deficiency or insulin activity

with symptoms of increased blood sugar levels (hyperglycemia) (Lestari et al., 2021; Pippitt et al.,

2016; Wu et al., 2014). Symptoms that often occur in people with DM include polyuri, polydipsy,

polypagi and weight loss (Lestari et al., 2021).

Kersen Leaf Tea’s Effects on Male Mice’s Liver and Kidney Functions Induced by Alloxan

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2022

People with DM are not a few who fall into complications. DM has been proven to impact

the functions of liver and kidney (Bahirwani & Reddy, 2009; Targher et al., 2018). Complications

that often arise include diabetic ketoacidosis, angiopathy, retinopathy and nephropathy (Forbes &

Cooper, 2013). Hemodynamic changes are considered as a result of changes in the metabolic

environment, the release of vasoactive factors, changes in signal transduction as well as intrinsic

defects in the glomerular arterioles as a cause of the onset of diabetic neoropathy (Forbes &

Cooper, 2013; Lestari et al., 2021).

METHOD

Tool

The tools used in this study include a mice cage, oven, blender, laminating, teabag container,

NGT sonde, 1 cc syringe, mice drinking water bottle, analysis scales, micro pipettes, incubators,

test tubes and stationery.

Material

The material used in this study was kersen leaf tea (Muntingia calabura L) which was added

from the Poltekkes page of the Ministry of Health of East Kalimantan. Kersen leaves are taken at

the ends of twigs that are dark green.

How to make kersen leaf tea

1) Material preparation: Kersen leaves that have been taken from a tree with criteria that are

old or dark green are separated from the stalk.

2) Sorting: Kersen leaves are separated from damaged or light or yellow hiiau colored and are

not eaten by caterpillars. Kersen leaves that are from prepared materials are then sorted or

sorted. Kersen leaves of the highest quality to be used as a material for making tea are dark

green and not yellowish, and do not have holes.

3) Washing: The selected kersen leaves are then washed in running water so that dirt in the

form of dust and fine hairs on the kersen leaves disappear.

4) Withering: Washed kersen leaves are then drained. Then heated to a temperature of 105 0

C-130

C for 15 minutes so that a withering process occurs to reduce the moisture content.

5) Plowing: Kersen leaves that have withered, then chopped thin thin, to optimize the drying

process.

6) Drying: Chopped leaves are then dried using a cabinet dryer oven for 170 minutes with a

temperature of 50

C (Lolok et al., 2019).

The dried kersen leaves are then puree using a blender. The already smooth tea is packaged

in teabag containers weighing 2 grams each. Kersen leaf tea is then brewed with hot water as much

as 100 ml of perdose and given as much as 0.52 ml morning and evening (2 times a day).

Experimental Animals

The experimental animal (study subject) used in this study was the white male mice (Mus

Musculus). There were 40 mice divided into 4 groups (K1 = Control group, K2 = dose group 2%,

Kersen Leaf Tea’s Effects on Male Mice’s Liver and Kidney Functions Induced by Alloxan

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2022

K3 = dose group 4%, and K4 = dose group 6%). The mice (Mus Musculus) used in this study were

11-12 weeks old and weighed between 20-30 grams.

Research Design

This study used a true experiment design with a pre-post control group design. The treatment

and maintenance of experimental animals is carried out at the Medical Laboratory Technology

Laboratory of the Poltekkes of the Ministry of Health, East Kalimantan. Male mice (Mus

Musculus) were randomized into 4 groups with each group consisting of 10. Mice (Mus Musculus)

are acclimatized for 7 days to condition the animal to the environment before treatment. Mice (Mus

Musculus) are placed in separate cages according to their respective groups and given standard

dietary pelleted feed and drink adlibitum water. On the 8

day of mice, induction was carried out

with Alloxan dose 65 mg / kg BB intravenously on the tail of the mice (Lucchesi et al., 2015).

Mice are made chronic DM for 1 week, on the 15th day an examination of blood sugar and insulin

levels is carried out. On the 16th day, kersen leaf tea began to be given for 14 days, which was

given morning and evening at a dose of 0.52 ml. On the 29

day (14 days of treatment) blood

sampling was carried out to check the levels of AST, ALT, Urium and Creatinine after treatment.

Levels of AST, ALT, Urium and Creatinine were examined at the Medical Laboratory Technology

Laboratory of the Poltekkes of the Ministry of Health, East Kalimantan.

Data Analysis

The data that has been collected was tested for Normality with Saphyro-Wilk because the

sample was less than 50. If the Saphyro-Wilk p> 0.05 test hail is obtained, the data is considered

normal and the One Way ANOVA test is carried out, the p<0.05 value is obtained, the data is

abnormal and the Kruskal Wallis alternative test is carried out. Then a pre and post test is carried

out using the Paired T Test test when the data is normal and if it is not normal, the Wilcoxon Test

is carried out.

RESULT AND DISCUSSION

In this study, the normality test results obtained a P value of <0.05 which means that the data

is abnormally distributed so that it uses the Kruskal-Wallis alternative test with the following

results.

Table 1. Test Results differ between groups with the Kruskal-Wallis Test

PostAST

PostALT

PostUreum

Postcreatinin

Kruskal-Wallis

29.195

12.807

2.660

12.237

Asymp. Itself.

.000

.005

.447

.007

Based on the results of the Kruskal-Wallis test in the table above, there are significant

differences between dose groups (P< 0.05) except for Urium levels (P> 0.05) meaning that there

is no difference between groups.

Kersen Leaf Tea’s Effects on Male Mice’s Liver and Kidney Functions Induced by Alloxan

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2022

Table 2. Pre and Post Test Results of Kersen Leaf Tea Administration with Wilcoxon Test

PostAST–

PreAST

PostALT–

PreALT

PostUreum–

PreUreum

Postcreatinin–

Precreatinin

Postgds–

Pregds

Asymp. Sig.

(2-tailed)

.000

.018

.037

.038

.000

Based on the Wilcoxon test results there is a significant difference between before treatment

and after treatment on all indicators. AST levels with a value of P = 0.000 means P<0.05 ALT

levels value P=0.018 meaning P<0.05, Ureum levels P=0.037 meaning P<0.05 and creatinine

levels P=0.038 meaning P<0.05.

Discussion

Based on table 2 above, there is a decrease in levels of AST, ALT, Urium and creatinine.

Kersen leaves contain various phytochemicals including saponins, flavonoids, tannins. Flavonoids

contained in Kersen leaves have kersen leaf extract administration can reduce levels of ALT /

SGPT, AST/SGOT enzymes (Lalihatu & Sudharmono, 2019; Zakaria et al., 2018). Flavonoids as

antioxidants have hepatoprotective activity in the concentration range of 1-100 g/mL increasing

cell viability and inhibiting cellular leakage of hepatocytes aspartate aminotransferase (AST) and

alanine aminotransferase (ALT) (Kočevar et al., 2007). Flavonoids can inhibit inflammation in

the kidneys by the pathway of decreasing urium creatinine levels and inhibition of the xanthin

oxidase pathway (Panche et al., 2016; Ren et al., 2020). Saponins can protect kidney function and

oxidative stress due to diabetic nephropathy through pathways as antioxidants and anti-

inflammatories (Mi et al., 2022).

Based on the results of the Wilcoxon test, all indicators showed a significant relationship

(P<0.05) between before the intervention and after the intervention with the administration of

Kersen Leaf Tea for 2 weeks in Alloxan-induced mice. Kersen Leaf Tea contains various

phytochemicals including flavonoids, saponins and tannins. Flavonoids contained in kersen leaves

are of various types, namely; flavones, flavonons, flavans, and biflavans (Zahara & Suryady,

2018). Flavonoids have a wide range of activity; Anti-inflammatory, anticholinesterase, steroid

genesis modulator, xanthine oxidase modulator, fights antibiotic resistance, disease-fighting

activities, and anti-depressants (Jäger & Saaby, 2011; Benche et al., 2016). Giving kersen leaf

extract (Muntingia Calabura L) at a dose of 50 mg / kgBB, 250 mg / KgBB, and 500 mg / KgBB

Male rats (male Sprague Dawley) can reduce levels of AST, ALT and ALP (Wahhab Rofiq Hakim,

2012; Zakaria et al., 2018). The administration of kersen leaf extract can improve liver and kidney

function (Fadil et al., 2017; Kholifaturrokhmah & Purnawati, 2016). Kersen leaves that contain a

lot of antioxidants can improve the protective mechanism against oxidative stress (Fadil et al.,

2017; Kholifaturrokhmah & Purnawati, 2016; Zakaria et al., 2018). Saponins contained in kersen

leaves can be antioxidants and anti-antioxidants in improving kidney function (Mi et al., 2022).

Administration of kersen leaf extract can improve proximal renal tubules in diabetic rats (Safrida

& Sabri, 2019). Research by Lalihatu et al, 2019, Kersen leaf decoction can reduce SGOT and

Kersen Leaf Tea’s Effects on Male Mice’s Liver and Kidney Functions Induced by Alloxan

2075 | I n d o n e s i a n J o u r n a l o f M u l t i d i s c i p l i n a r y S c i e n c e , 2 ( 3 ) , Dec,

2022

SGPT levels in Wistar Rats with Acute Hepatitis (Lalihatu & Sudharmono, 2019). Kersen leaves

have a variety of activities including antimicrobial, anti-inflammatory, antinociseptic, anticancer,

antiulcer, antioxidant and gastroprotektic (Mahmood et al., 2014; Pereira et al., 2018).

CONCLUSION

In this study, the administration of kersen leaf tea can reduce levels of AST, ALT, Ureum and

Creatinine. It proves that consuming kersen leaf tea is safe against liver function and kidney

function. In addition, it is important to research this topic further to gain more in-depth insight

regarding DM affects liver and kidney functions.

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