KARYA TULIS AKHIR

HUBUNGAN LINGKAR PINGGANG DENGAN DISLIPDEMIA PADA

REMAJA LATE ADOLESCENCE

Oleh:

Rasyid Ridho

201510330311006

UNIVERSITAS MUHAMMADIYAH MALANG

FAKULTAS KEDOKTERAN

2019

ii

HASIL PENELITIAN

HUBUNGAN LINGKAR PINGGANG DENGAN DISLIPDEMIA PADA

REMAJA LATE ADOLESCENCE

KARYA TULIS AKHIR

Diajukan kepada

Universitas Muhammadiyah Malang

untuk Memenuhi Salah Satu Persyaratan

dalam Menyelesaikan Program Sarjana

Fakultas Kedokteran

Oleh:

Rasyid Ridho

201510330311006

UNIVERSITAS MUHAMMADIYAH MALANG

FAKULTAS KEDOKTERAN

2019

iii

iv

v

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KATA PENGANTAR

Puji syukur penulis panjatkan kehadirat Allah SWT karena atas berkat dan

rahmat-Nya, penulis telah berhasil menyelesaikan proposal penelitian yang

berjudul “Hubungan Lingkar Pinggang Dengan Dislipidemia pada remaja Late

Adolescence”. Penulisan penelitian ini dilakukan dalam rangka memenuhi salah

satu syarat untuk mencapai gelar Sarjana Kedokteran Jurusan Pendidikan Dokter

pada Fakultas Kedokteran Universitas Muhammadiyah Malang.

Penulis menyadari bahwa penyusunan proposal penelitian ini jauh dari

sempurna. Tanpa bantuan dan dorongan dari berbagai pihak, sangatlah tidak

mudah menjalani masa perkuliahan hingga pada penyusunan karya tulis akhir.

Akhir kata penulis berharap adanya saran dan kritik yang membangun dan

semoga penelitian ini dapat menambah wawasan serta bermanfaat bagi semua

pihak.

Malang, Juni 2019

Penulis

vii

DAFTAR ISI

LEMBAR PENGESAHAN ............................................................................. iii

PERNYATAAN ORISINALITAS .................................................................. iv

LEMBAR PENGUJIAN .................................................................................. v

KATA PENGANTAR ..................................................................................... vi

LEMBAR PERSEMBAHAN .......................................................................... vii

ABSTRAK ....................................................................................................... x

ABSTRACT ....................................................................................................... xi

DAFTAR ISI ................................................................................................... xii

DAFTAR GAMBAR ...................................................................................... xvi

DAFTAR TABEL ........................................................................................... xvii

DAFTAR SINGKATAN ................................................................................ xviii

DAFTAR LAMPIRAN .................................................................................... xix

BAB 1 PENDAHULUAN .............................................................................. 1

1.1 Latar Belakang .............................................................................. 1

1.2 Rumusan Masalah ......................................................................... 3

1.3 Tujuan Penelitian ........................................................................... 4

1.3.1. Tujuan Umum .................................................................. 4

1.3.2. Tujuan Khusus ................................................................. 4

1.4 Manfaat Penelitian ......................................................................... 4

1.4.1 Manfaat Akademis ............................................................. 4

1.4.2 Manfaat Klinis ................................................................... 5

1.4.3 Manfaat Masyarakat .......................................................... 5

viii

BAB 2 TINJAUAN PUSTAKA ..................................................................... 6

2.1. Lingkar Pinggang ......................................................................... 6

2.1.1. Definisi Lingkar Pinggang ................................................ 6

2.1.2. Kriteria Ukuran Lingkar Pinggang ................................... 6

2.1.3. Faktor Yang Memengaruhi Lingkar Pinggang ................. 7

2.1.4. Pengukuran Lingkar Pinggang .......................................... 10

2.2. Profil Lipid Darah ......................................................................... 11

2.2.1. Lipid dan Lipoprotein ....................................................... 11

2.2.2. Fosfolipid .......................................................................... 13

2.2.3 Trigliserida ......................................................................... 15

2.2.4 Kolesterol ........................................................................... 16

2.3. Metabolisme Lipoprotein .............................................................. 18

2.3.1. Pengertian Metabolisme Lipoprotein ............................... 18

2.3.2. Jalur Metabolisme Eksogen .............................................. 18

2.3.3. Jalur Metabolisme Endogen .............................................. 19

2.3.4 Jalur Reverse Cholesterol Transport ................................ 20

2.4. High Density Lipoprotein .............................................................. 22

2.5. Low Density Lipoprotein ............................................................... 23

2.6. Sindroma Metabolik ...................................................................... 24

2.6.1 Definisi Sindroma Metabolik ............................................. 24

2.6.2 Faktor Risiko Sindroma Metabolik .................................... 26

BAB 3 KERANGKA KONSEP DAN HIPOTESIS PENELITIAN .............. 32

3.1. Kerangka Konseptual Penelitian .................................................. 32

3.2. Hipotesis Penelitian ...................................................................... 34

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BAB 4 METODE PENELITIAN..................................................................... 35

4.1. Jenis dan Rancangan Penelitian ................................................... 35

4.2. Lokasi dan waktu Penelitian ........................................................ 35

4.3. Populasi dan Sampel .................................................................... 35

4.3.1. Populasi ............................................................................ 35

4.3.2. Sampel ............................................................................. 35

4.3.3. Besar Sampel ................................................................... 35

4.3.4. Teknik Pengambilan sampel ............................................ 36

4.3.5. Karakteristik Sampel Penelitian ....................................... 36

4.3.5.1. Kriteria Inklusi ..................................................... 36

4.3.4.2. Kriteria Eksklusi ................................................... 36

4.3.5.3. Kriteria Drop Out ................................................. 37

4.4. Variabel Penelitian ....................................................................... 37

4.4.1. Variabel Bebas .................................................................. 37

4.4.2. Variabel Tergantung ......................................................... 37

4.5. Definisi Operasional Penelitian .................................................... 37

4.5.1. Lingkar Pinggang .............................................................. 37

4.5.2. Dislipidemia ...................................................................... 37

4.6. Instrumen Penelitian ..................................................................... 38

4.7. Prosedur Penelitian ...................................................................... 38

4.8. Alur Penelitian .............................................................................. 39

BAB 5 HASIL DAN ANALISIS PENELITIAN............................................. 40

5.1 Hasil Penelitian .............................................................................. 40

x

5.1.1 Gambaran Karakteristik Lingkar Pinggang Berdasarkan

Jenis Kelamin .............................................................................. 40

5.1.2 Gambaran Karakter Profil Lipid Berdasrkan Jenis

Kelamin ....................................................................................... 41

5.1.3 Uji Hubungan Lingkar Pinggang Dengan Profil Lipid ...... 42

BAB 6 PEMBAHASAN .................................................................................. 46

6.1 Hasil ............................................................................................... 46

6.2 Keterbatasan Penelitian .................................................................. 50

BAB 7 KESIMPULAN DAN SARAN............................................................ 52

7.1 Kesimpulan ..................................................................................... 52

7.2 Saran ............................................................................................... 52

DAFTAR PUSTAKA ...................................................................................... 53

LAMPIRAN ..................................................................................................... 59

xi

DAFTAR GAMBAR

Gambar Halaman

2.1. Langkah langkah Prosedur Pengukuran Lingkar Pinggang.................... 11

2.2. Struktur Kimia Trigliserida .................................................................... 15

2.3. Struktur Kimia Kolesterol ...................................................................... 17

2.4. Jalur Metabolisme Lipoprotein ............................................................... 21

2.5. Kerangka Konseptual.............................................................................. 32

xii

DAFTAR TABEL

Tabel Halaman

2.1. Nilai Lingkar Pinggang Berdasarkan Etnis ............................................. 7

2.2. Karakteristik Beberapa Apolipoprotein .................................................. 12

2.3. Karakteristik Lipoprotein Plasma ........................................................... 13

5.1 Hasil Pengukuran Lingkar Pinggang Perempuan ................................... 40

5.2 Hasil Pengukuran Lingkar Pinggang Laki-laki ...................................... 40

5.3 Hasil Pengukuran Profil Lipid Perempuan ............................................. 41

5.4 Hasil Pengukuran Profil Lipid Laki-laki ................................................ 41

5.5 Hasil Uji Hubungan Lingkar Pinggang Dengan Dislipidemia pada

perempuan .............................................................................................. 42

5.6 Uji fisher pada Perempuan ..................................................................... 43

5.7 Hasil Uji Hubungan Lingkar Pinggang Dengan Dislipidemia pada

laki-laki ................................................................................................... 44

5.8 Uji Fisher pada Laki-laki........................................................................ 45

xiii

DAFTAR SINGKATAN

AACE: American Association of Clinical Endocrinologist

ABC-1: Adenosine Triphosphate-binding Cassete Transporter-1

CETP: Cholesterol Ester Transfer Protein

DM: Diabetes Mellitus

EGIR: European Group for the study of Insulin Resistance

FFA: Free Fatty Acid

HDL: High Density Lipoprotein

IDF: International Diabetes Federation

IMT: Indeks Massa Tubuh

LCAT: Lecithin Cholesterol Acyltransferase

LDL: Low Density Lipoprotein

LPL: Lipoprotein Lipase

NCEP-ATP III: National Cholesterol Education Program third Adult Traetment

Panel

NEFA: Non-Esterified Fatty Acid

TG: Trigliserida Darah

VLDL: Very Low Density Lipoprotein

WHO: World Health Organization

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DAFTAR LAMPIRAN

Lampiran Halaman

1. Lembar Informasi Untuk Responden ........................................................ 59

2. Informed Consent ...................................................................................... 60

3. Pedoman Wawancara ................................................................................ 61

4. Lembar Pengukuran .................................................................................. 63

5. Hasil Uji Analisis ...................................................................................... 64

6. Dokumentasi Penelitian ............................................................................ 66

7. Keterangan Kelaikan Etik ......................................................................... 67

8. Kartu Konsultasi Tugas Akhir .................................................................. 68

9. Surat Keterangan Lolos Kaji Ilmiah ......................................................... 69

10. Hasil Deteksi Plagiasi ............................................................................... 70

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