Pengaruh Pemberian Ekstrak Teh Hijau (Camellia sinensis L.) terhadap Penurunan Kadar Kolesterol Total Tikus Wistar (Rattus Norvegicus) Diabetes Induksi Aloksan
Keywords:
Alloxan; Diabetic; Green Tea; Total Cholesterol
Abstract
Green Tea works as an anti-dyslipidemia due to chronic hyperglycemia of diabetes through its flavonoid content. The purpose of this study was to determine the effectiveness of green tea extracts on reducing the total cholesterol levels of alloxan-induced diabetes Wistar rats. The study design uses true experimental. Samples were 30 Wistar strain male white rats, aged 8-12 weeks, weighing ±200 grams. Green tea extract doses of 200, 400, and 800 mg/kg body weight, and negative controls were given alloxan, and positive controls were given simvastatin. The treatment group except the normal group was injected with a dose of 125 mg/kg alloxan intraperitoneally and a high-fat feed. After 3 days blood from the tail was measured glucose using a glucometer and cholesterol with a spectrophotometer λ=546 nm, giving green tea extract for 16 days orally, then re-measuring blood cholesterol from the tail. The One Way Anova Test results show the effectiveness of green tea extract on reducing total cholesterol (p=0,000). The results of the Post-Hoc Bonferroni test giving green tea extract at a dose of 400 mg/kg were comparable to simvastatin (p=0.453) which best decreased total cholesterol levels close to normal values.
Downloads
Download data is not yet available.
References
PERKENI. Konsensus Pengelolaan dan Pencegahan Diabetes Melitus Tipe 2 di Indonesia. Konsensus Pengelolaan dan Pencegah Diabetes Melitus Tipe 2 di Indones. 2015;1–93.
World Health Organization. Monitoring Health For SDGs Sustainable Development Goals. World Heal Organ [Internet]. 2018;1–86. Available from: https://www.who.int/gho/publications/world_health_statistics/2018/en/
World Health Organization. Global Report on Diabetes. Isbn [Internet]. 2016;978:88. Available from: http://www.who.int/about/licensing/%5Cnhttp://apps.who.int/iris/ bitstream/10665/204871/1/9789241565257_eng.pdf
Kementerian Kesehatan. CEGAH, CEGAH, dan CEGAH: Suara Dunia Perangi Diabetes [Internet]. 2018 p. 2018–20. Available from: http://www.depkes.go.id/article/view/18121200001/prevent-prevent-and-prevent-the-voice-of-the-world-fight-diabetes.html
IDF. IDF DIABETES ATLAS. Lancet [Internet]. 2017;1–150. Available from: http://fmdiabetes.org/wp-content/uploads/2018/03/IDF-2017.pdf
IDF. IDF Diabetes Atlas Ninth. Dunia IDF [Internet]. 2019;1–14. Available from: http://www.idf.org/about-diabetes/facts-figures
Schofield JD, Liu Y, Rao-Balakrishna P, Malik RA, Soran H. Diabetes Dyslipidemia. Diabetes Ther [Internet]. 2016;7(2):203–19. Available from: https://doi.org/10.1007/s13300-016-0167-x
Rodriguez-Araujo G, Nakagami H. Pathophysiology of cardiovascular disease in diabetes mellitus. Cardiovasc Endocrinol Metab [Internet]. 2018;7(1):4–9. Available from: https://doi.org/10.1097/XCE.0000000000000141
Hirano T. Pathophysiology of diabetic dyslipidemia. J Atheroscler Thromb [Internet]. 2018;25(9):771–82. Available from: https://doi.org/10.5551/jat.RV17023
PERKI. panduan tata laksana dislipidemia 2017. J Kardiol Indones [Internet]. 2017;(April 2017):1–80. Available from: http://www.inaheart.org/upload/file/Pedoman_ tatalksana_Dislipidemia.pdf
Gilman G&. Dasar Farmakologi Terapi. 10th ed. Joel. G. Hardman & Lee E. Limbird, Gilman AG, editors.
Ji X, Shi S, Liu B, Shan M, Tang D, Zhang W, et al. Bioactive compounds from herbal medicines to manage dyslipidemia. Biomed Pharmacother [Internet]. 2019;118(July):109338. Available from: https://doi.org/10.1016/j.biopha.2019.109338
Rabie’ah, Carlos FK, Griselda J, Sari WP, Kusumawardhani S, Tendean M. Tatalaksana {Terkini} {Dislipidemia}. J Kedokt Meditek [Internet]. 2014;20(54):28–33. Available from: http://ejournal.ukrida.ac.id/ojs/index.php/Ked/article/view/1022
Salomo H, Busman H, Apriliana E. Pengaruh Pemberian Metformin dan Ekstrak Daun Teh Hijau pada Penurunan Berat Badan Tikus Putih ( Rattus norvegicus ) Galur Sprague Dawley dengan Diet Tinggi Lemak. Med J Lampung Univ [Internet]. 2018;7(2):65–70. Available from: https://juke.kedokteran.unila.ac.id/index.php/ majority/article/view/1853
Rohdiana D. Teh : 2015;(December). Available from: https://www.researchgate.net/ publication/286460235
Leslie PJ, Gunawan S. Daun, Uji fitokimia dan perbandingan efek antioksidan pada teh hijau, teh hitam, dan teh putih (Camellia sinensis) dengan metode DPPH (2, 2-difenil-1- pikrilhidrazil). Tarumanagara Med J [Internet]. 2019;Vol. 1, No(2):383–8. Available from: https://journal.untar.ac.id/index.php/tmj/article/view/3841
Adelina R. Mekanisme Katekin Sebagai Obat Antidislipidemia (Uji In Silico). Bul Penelit Kesehat [Internet]. 2018;46(3):147–54. Available from: https://doi.org/10.22435/bpk.v46i3.899
Ahmad RS, Butt MS, Sultan MT, Mushtaq Z, Ahmad S, Dewanjee S, et al. Preventive role of green tea catechins from obesity and related disorders especially hypercholesterolemia and hyperglycemia. J Transl Med [Internet]. 2015;13(1):1–9. Available from: https://doi.org/10.1186/s12967-015-0436-x
Kobayashi M, Ikeda I. Mechanisms of inhibition of cholesterol absorption by green tea catechins. Food Sci Technol Res [Internet]. 2017;23(5):627–36. Available from: https://doi.org/10.3136/fstr.23.627
Jin-Ming M, Shi-yu C, Xin Lin W, Ren You G, Yuan Feng W, Shu Xian C, et al. Effects and mechanisms of tea for the prevention and management of diabetes mellitus and diabetic complications: An updated review. Antioxidants [Internet]. 2019;8(170):1–25. Available from: https://doi.org/10.3390/antiox8060170
Haidari F, Shahi MM, Zarei M, Rafiei H, Omidian K. Effect of green tea extract on body weight, serum glucose and lipid profile in streptozotocin-induced diabetic rats: A dose response study. Saudi Med J [Internet]. 2012;33(2):128–33. Available from: https://www.researchgate.net/publication/235637252%0A%0A
Mostafa, El-Sayed U. Effect of green tea and green tea rich with catechin on blood glucose levels, serum lipid profile and liver and kidney functions in diabetic rats. Jordan J Biol Sci. 2014;7(1):7–12.
Ojiako OA, Chikezie PC, Ogbuji AC. Blood glucose level and lipid profile of alloxan-induced hyperglycemic rats treated with single and combinatorial herbal formulations. J Tradit Complement Med [Internet]. 2015;6(2):1–9. Available from: http://dx.doi.org/10.1016/j.jtcme.2014.12.005
Rahmawati FC, Djamiatun K, Suci N. Pengaruh yogurt sinbiotik pisang terhadap kadar glukosa dan insulin tikus sindrom metabolik. J Gizi Klin Indones [Internet]. 2017;14(1):10. Available from: https://doi.org/10.22146/ijcn.19379
Nugraha MR, Hasanah AN. Metode Pengujian Aktifitas Antidiabetes. Farmaka [Internet]. 2018;16(3):28–34. Available from: http://jurnal.unpad.ac.id/farmaka/article/ viewFile/17298/pdf %0A%0A
Ighodaro OM, Adeosun AM, Akinloye OA. Alloxan-induced diabetes, a common model for evaluating the glycemic-control potential of therapeutic compounds and plants extracts in experimental studies. Med [Internet]. 2017;53(6):365–74. Available from: https://doi.org/10.1016/j.medici.2018.02.001
Cahyaningrum, P, L, Yuliari, S, A, M, Suta, I, B, P. Uji Aktivitas Antidiabetes dengan ekstrak buah Amla( Phyllanthus Emblica L) pada mencit Balb/c yang diinduksi aloksan. J Vocat Heal Stud [Internet]. 2019;6–10:53–8. Available from: https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=3&cad=rja&uact=8&ved=2ahUKEwio1bq57qvpAhVA83MBHY6YCA8QFjACegQIAxAB&url=https%3A%2F%2Fe-journal.unair.ac.id%2FJVHS%2Farticle%2Fdownload%2F16841%2F9055&usg=AOvVaw3jsV9guDYy0yF9aormrrir%0A
Nainggolan H, Saragih H, Ricky, D R, Hutapea, A M. Nanocurcumin Sebagai Penurun Kadar Glukosa Darah Pada Tikus Wistar Diabetes. Pros Simp Fis Nas XXV. 2012;189–200.
ADA. Standards Of Medical Care in Diabetes-2017”, The Journal Of Clinical And Applied Research and Education. J Clin Apllied Res Educ. 2017;40(1):1–135.
Guo X xuan, Wang Y, Wang K, Ji B ping, Zhou F. Stability of a type 2 diabetes rat model induced by high-fat diet feeding with low-dose streptozotocin injection. J Zhejiang Univ Sci B [Internet]. 2018;19(7):559–69. Available from: https://doi.org/10.1631/jzus.B1700254
Dave M, Gupta AK, Patel P, Heernath H. Correlation between Fasting Blood Sugar Level, HbA1C Level and Serum Lipid Levels in Type 2 Diabetes Mellitus Patients. Int J Contemp Med Res [IJCMR]. 2019;6(7).
King A, Austin A. Animal Models of Type 1 and Type 2 Diabetes Mellitus [Internet]. Second Edi. Animal Models for the Study of Human Disease. Elsevier Inc.; 2017. 245–65 p. Available from: http://dx.doi.org/10.1016/B978-0-12-809468-6/00010-3
Maiti S, Nazmeen A, Medda N, Patra R, Ghosh TK. Flavonoids green tea against oxidant stress and inflammation with related human diseases. Clin Nutr Exp [Internet]. 2019;24:1–14. Available from: https://doi.org/10.1016/j.yclnex.2018.12.004
Hardoko, AB B, Sasmito, Bambang B, Halim Y. Antidiabetic Activity of Herbal Green Tea Extract from White Mangrove (Avicennia marina) Leaves towards Blood Glucose Level of Diabetic Wistar Rats (Rattus novergicus) Hardokoa,. Int J Food Stud [Internet]. 2019;8:43–52. Available from: https://www.iseki-food-ejournal.com/ojs/index.php/e-journal/article/view/553
Isnawati A, Adelina R. Studi Docking Molekuler Catechin Gallate, Epicatechin Gallate, Gallocatechin Gallate, dan Epigallocatechin Gallate sebagai Obat Dislipidemia. J Kefarmasian Indones [Internet]. 2015;5(1):25–32. Available from: https://doi.org/10.22435/jki.v5i1.4083.25-32
Gupta J, Afzal M. In Vivo Assesment Of Possible Toxicity Risks Of Green Tea Extract In Mice. Int J Bioassays [Internet]. 2015;4(2):3636–41. Available from: https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&ved=2ahUKEwjutrqetP_pAhUW6nMBHa-mDQsQFjAAegQIBhAB&url=https%3A%2F%2Fwww .ijbio.com%2Farticles%2Fin-vivo-assessment-of-possible-toxicity-risks-of-green-tea-extract-in-mice.pdf&usg=AOvVaw1PTK4L88
World Health Organization. Monitoring Health For SDGs Sustainable Development Goals. World Heal Organ [Internet]. 2018;1–86. Available from: https://www.who.int/gho/publications/world_health_statistics/2018/en/
World Health Organization. Global Report on Diabetes. Isbn [Internet]. 2016;978:88. Available from: http://www.who.int/about/licensing/%5Cnhttp://apps.who.int/iris/ bitstream/10665/204871/1/9789241565257_eng.pdf
Kementerian Kesehatan. CEGAH, CEGAH, dan CEGAH: Suara Dunia Perangi Diabetes [Internet]. 2018 p. 2018–20. Available from: http://www.depkes.go.id/article/view/18121200001/prevent-prevent-and-prevent-the-voice-of-the-world-fight-diabetes.html
IDF. IDF DIABETES ATLAS. Lancet [Internet]. 2017;1–150. Available from: http://fmdiabetes.org/wp-content/uploads/2018/03/IDF-2017.pdf
IDF. IDF Diabetes Atlas Ninth. Dunia IDF [Internet]. 2019;1–14. Available from: http://www.idf.org/about-diabetes/facts-figures
Schofield JD, Liu Y, Rao-Balakrishna P, Malik RA, Soran H. Diabetes Dyslipidemia. Diabetes Ther [Internet]. 2016;7(2):203–19. Available from: https://doi.org/10.1007/s13300-016-0167-x
Rodriguez-Araujo G, Nakagami H. Pathophysiology of cardiovascular disease in diabetes mellitus. Cardiovasc Endocrinol Metab [Internet]. 2018;7(1):4–9. Available from: https://doi.org/10.1097/XCE.0000000000000141
Hirano T. Pathophysiology of diabetic dyslipidemia. J Atheroscler Thromb [Internet]. 2018;25(9):771–82. Available from: https://doi.org/10.5551/jat.RV17023
PERKI. panduan tata laksana dislipidemia 2017. J Kardiol Indones [Internet]. 2017;(April 2017):1–80. Available from: http://www.inaheart.org/upload/file/Pedoman_ tatalksana_Dislipidemia.pdf
Gilman G&. Dasar Farmakologi Terapi. 10th ed. Joel. G. Hardman & Lee E. Limbird, Gilman AG, editors.
Ji X, Shi S, Liu B, Shan M, Tang D, Zhang W, et al. Bioactive compounds from herbal medicines to manage dyslipidemia. Biomed Pharmacother [Internet]. 2019;118(July):109338. Available from: https://doi.org/10.1016/j.biopha.2019.109338
Rabie’ah, Carlos FK, Griselda J, Sari WP, Kusumawardhani S, Tendean M. Tatalaksana {Terkini} {Dislipidemia}. J Kedokt Meditek [Internet]. 2014;20(54):28–33. Available from: http://ejournal.ukrida.ac.id/ojs/index.php/Ked/article/view/1022
Salomo H, Busman H, Apriliana E. Pengaruh Pemberian Metformin dan Ekstrak Daun Teh Hijau pada Penurunan Berat Badan Tikus Putih ( Rattus norvegicus ) Galur Sprague Dawley dengan Diet Tinggi Lemak. Med J Lampung Univ [Internet]. 2018;7(2):65–70. Available from: https://juke.kedokteran.unila.ac.id/index.php/ majority/article/view/1853
Rohdiana D. Teh : 2015;(December). Available from: https://www.researchgate.net/ publication/286460235
Leslie PJ, Gunawan S. Daun, Uji fitokimia dan perbandingan efek antioksidan pada teh hijau, teh hitam, dan teh putih (Camellia sinensis) dengan metode DPPH (2, 2-difenil-1- pikrilhidrazil). Tarumanagara Med J [Internet]. 2019;Vol. 1, No(2):383–8. Available from: https://journal.untar.ac.id/index.php/tmj/article/view/3841
Adelina R. Mekanisme Katekin Sebagai Obat Antidislipidemia (Uji In Silico). Bul Penelit Kesehat [Internet]. 2018;46(3):147–54. Available from: https://doi.org/10.22435/bpk.v46i3.899
Ahmad RS, Butt MS, Sultan MT, Mushtaq Z, Ahmad S, Dewanjee S, et al. Preventive role of green tea catechins from obesity and related disorders especially hypercholesterolemia and hyperglycemia. J Transl Med [Internet]. 2015;13(1):1–9. Available from: https://doi.org/10.1186/s12967-015-0436-x
Kobayashi M, Ikeda I. Mechanisms of inhibition of cholesterol absorption by green tea catechins. Food Sci Technol Res [Internet]. 2017;23(5):627–36. Available from: https://doi.org/10.3136/fstr.23.627
Jin-Ming M, Shi-yu C, Xin Lin W, Ren You G, Yuan Feng W, Shu Xian C, et al. Effects and mechanisms of tea for the prevention and management of diabetes mellitus and diabetic complications: An updated review. Antioxidants [Internet]. 2019;8(170):1–25. Available from: https://doi.org/10.3390/antiox8060170
Haidari F, Shahi MM, Zarei M, Rafiei H, Omidian K. Effect of green tea extract on body weight, serum glucose and lipid profile in streptozotocin-induced diabetic rats: A dose response study. Saudi Med J [Internet]. 2012;33(2):128–33. Available from: https://www.researchgate.net/publication/235637252%0A%0A
Mostafa, El-Sayed U. Effect of green tea and green tea rich with catechin on blood glucose levels, serum lipid profile and liver and kidney functions in diabetic rats. Jordan J Biol Sci. 2014;7(1):7–12.
Ojiako OA, Chikezie PC, Ogbuji AC. Blood glucose level and lipid profile of alloxan-induced hyperglycemic rats treated with single and combinatorial herbal formulations. J Tradit Complement Med [Internet]. 2015;6(2):1–9. Available from: http://dx.doi.org/10.1016/j.jtcme.2014.12.005
Rahmawati FC, Djamiatun K, Suci N. Pengaruh yogurt sinbiotik pisang terhadap kadar glukosa dan insulin tikus sindrom metabolik. J Gizi Klin Indones [Internet]. 2017;14(1):10. Available from: https://doi.org/10.22146/ijcn.19379
Nugraha MR, Hasanah AN. Metode Pengujian Aktifitas Antidiabetes. Farmaka [Internet]. 2018;16(3):28–34. Available from: http://jurnal.unpad.ac.id/farmaka/article/ viewFile/17298/pdf %0A%0A
Ighodaro OM, Adeosun AM, Akinloye OA. Alloxan-induced diabetes, a common model for evaluating the glycemic-control potential of therapeutic compounds and plants extracts in experimental studies. Med [Internet]. 2017;53(6):365–74. Available from: https://doi.org/10.1016/j.medici.2018.02.001
Cahyaningrum, P, L, Yuliari, S, A, M, Suta, I, B, P. Uji Aktivitas Antidiabetes dengan ekstrak buah Amla( Phyllanthus Emblica L) pada mencit Balb/c yang diinduksi aloksan. J Vocat Heal Stud [Internet]. 2019;6–10:53–8. Available from: https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=3&cad=rja&uact=8&ved=2ahUKEwio1bq57qvpAhVA83MBHY6YCA8QFjACegQIAxAB&url=https%3A%2F%2Fe-journal.unair.ac.id%2FJVHS%2Farticle%2Fdownload%2F16841%2F9055&usg=AOvVaw3jsV9guDYy0yF9aormrrir%0A
Nainggolan H, Saragih H, Ricky, D R, Hutapea, A M. Nanocurcumin Sebagai Penurun Kadar Glukosa Darah Pada Tikus Wistar Diabetes. Pros Simp Fis Nas XXV. 2012;189–200.
ADA. Standards Of Medical Care in Diabetes-2017”, The Journal Of Clinical And Applied Research and Education. J Clin Apllied Res Educ. 2017;40(1):1–135.
Guo X xuan, Wang Y, Wang K, Ji B ping, Zhou F. Stability of a type 2 diabetes rat model induced by high-fat diet feeding with low-dose streptozotocin injection. J Zhejiang Univ Sci B [Internet]. 2018;19(7):559–69. Available from: https://doi.org/10.1631/jzus.B1700254
Dave M, Gupta AK, Patel P, Heernath H. Correlation between Fasting Blood Sugar Level, HbA1C Level and Serum Lipid Levels in Type 2 Diabetes Mellitus Patients. Int J Contemp Med Res [IJCMR]. 2019;6(7).
King A, Austin A. Animal Models of Type 1 and Type 2 Diabetes Mellitus [Internet]. Second Edi. Animal Models for the Study of Human Disease. Elsevier Inc.; 2017. 245–65 p. Available from: http://dx.doi.org/10.1016/B978-0-12-809468-6/00010-3
Maiti S, Nazmeen A, Medda N, Patra R, Ghosh TK. Flavonoids green tea against oxidant stress and inflammation with related human diseases. Clin Nutr Exp [Internet]. 2019;24:1–14. Available from: https://doi.org/10.1016/j.yclnex.2018.12.004
Hardoko, AB B, Sasmito, Bambang B, Halim Y. Antidiabetic Activity of Herbal Green Tea Extract from White Mangrove (Avicennia marina) Leaves towards Blood Glucose Level of Diabetic Wistar Rats (Rattus novergicus) Hardokoa,. Int J Food Stud [Internet]. 2019;8:43–52. Available from: https://www.iseki-food-ejournal.com/ojs/index.php/e-journal/article/view/553
Isnawati A, Adelina R. Studi Docking Molekuler Catechin Gallate, Epicatechin Gallate, Gallocatechin Gallate, dan Epigallocatechin Gallate sebagai Obat Dislipidemia. J Kefarmasian Indones [Internet]. 2015;5(1):25–32. Available from: https://doi.org/10.22435/jki.v5i1.4083.25-32
Gupta J, Afzal M. In Vivo Assesment Of Possible Toxicity Risks Of Green Tea Extract In Mice. Int J Bioassays [Internet]. 2015;4(2):3636–41. Available from: https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&ved=2ahUKEwjutrqetP_pAhUW6nMBHa-mDQsQFjAAegQIBhAB&url=https%3A%2F%2Fwww .ijbio.com%2Farticles%2Fin-vivo-assessment-of-possible-toxicity-risks-of-green-tea-extract-in-mice.pdf&usg=AOvVaw1PTK4L88
Published
2020-06-14
How to Cite
Sarel, Z., & Simanjuntak, K. (2020). Pengaruh Pemberian Ekstrak Teh Hijau (Camellia sinensis L.) terhadap Penurunan Kadar Kolesterol Total Tikus Wistar (Rattus Norvegicus) Diabetes Induksi Aloksan. Jurnal Sehat Mandiri, 15(1), 98-111. https://doi.org/https://doi.org/10.33761/jsm.v15i1.195
Section
Articles
Copyright Notice
Pernyataan Hak Cipta dan Lisensi
Dengan mengirimkan manuskrip ke Jurnal Sehat Mandiri, penulis setuju dengan kebijakan ini. Tidak diperlukan persetujuan dokumen khusus.
Hak Cipta :
Lisensi Creative Commons Atribusi-NonKomersial-BerbagiSerupa 4.0 Internasional
Hak cipta atas artikel apa pun di Jurnal Sehat Mandiri dipegang penuh oleh penulisnya di bawah lisensi Creative Commons CC BY-NC-SA 4.0.
- Hak cipta pada setiap artikel adalah milik penulis.
- Penulis mempertahankan semua hak mereka atas karya yang diterbitkan, tak terbatas pada hak-hak yang diatur dalam laman ini.
- Penulis mengakui bahwa Jurnal Sehat Mandiri sebagai yang pertama kali mempublikasikan dengan lisensi Creative Commons Atribusi 4.0 Internasional (CC BY-NC-SA-4.0).
- Penulis dapat memasukan tulisan secara terpisah, mengatur distribusi non-ekskulif dari naskah yang telah terbit di jurnal ini kedalam versi yang lain (misal: dikirim ke respository institusi penulis, publikasi kedalam buku, dll), dengan mengakui bahwa naskah telah terbit pertama kali pada Jurnal Sehat Mandiri.
- Penulis menjamin bahwa artikel asli, ditulis oleh penulis yang disebutkan, belum pernah dipublikasikan sebelumnya, tidak mengandung pernyataan yang melanggar hukum, tidak melanggar hak orang lain, tunduk pada hak cipta yang secara eksklusif dipegang oleh penulis.
- Jika artikel dipersiapkan bersama oleh lebih dari satu penulis, setiap penulis yang mengirimkan naskah menjamin bahwa dia telah diberi wewenang oleh semua penulis bersama untuk menyetujui hak cipta dan pemberitahuan lisensi (perjanjian) atas nama mereka, dan setuju untuk memberi tahu rekan penulis persyaratan kebijakan ini. Jurnal Sehat Mandiri tidak akan dimintai pertanggungjawaban atas apa pun yang mungkin timbul karena perselisihan internal penulis.
Lisensi :
Jurnal Sehat Mandiri diterbitkan berdasarkan ketentuan Lisensi Creative Commons Atribusi-NonKomersial-BerbagiSerupa 4.0 Internasional (CC BY-NC-SA 4.0). Lisensi ini mengizinkan setiap orang untuk :
Menyalin dan menyebarluaskan kembali materi ini dalam bentuk atau format apapun serta menggubah, memperbaiki, dan membuat ciptaan turunan, bahkan untuk kepentingan komersial, selama mereka mencantumkan kredit kepada Penulis atas ciptaan asli.
