Kesimpulan Saran KESIMPULAN DAN SARAN

62

BAB V KESIMPULAN DAN SARAN

A. Kesimpulan

Lingkar pinggang dan rasio lingkar pinggang-panggul memiliki korelasi positif yang tidak bermakna dengan kekuatan korelasi sangat lemah terhadap kadar glukosa darah puasa pada mahasiswa dan mahasiswi kampus III Universitas Sanata Dharma Yogyakarta.

B. Saran

1. Perlu dilakukan penelitian lanjutan dengan kelompok usia yang berbeda dan dengan memperluas jumlah sampel yaitu di populasi masyarakat Yogyakarta. 2. Perlu dilakukan penelitian lanjutan dengan pemeriksaan TTGO. 63 Daftar Pustaka Adam, J.M.F., 2006, Obesitas dan Sindroma Metabolik, Bandung, pp. 1-8. Alattar, A., Al-Majed, Hana, Almuaili, T., Almutairi, O., Shaghouli, A., Altorah, W., 2012, Prevalence of Impaired Glucose Regulation in Asymptomatic Kuwaiti Young Adults, Med Princ Pract 2012, 21, pp: 52-53. Al-khazrajy, Lujain Anwar, Yosif Abdul Raheem, dan Yossra Khalaf Hanoon, 2010, Sex Differences in the Impact of Body Mass Index BMI and WaistHip WH Ratio on Patients with Metabolic Risk Factors in Baghdad, Global Journal of Health Science, 2 2, pp. 162. Appel, S., Jones, E., dan Kennedy-Malone, L., 2004, Central Obesity and The Metabolic Syndrome: Implications for Primary Care Providers, Journal of the American Academy of Nurse Practitioners, 168, pp: 338. Bringham and Women’s Hospital, 2012, Bigger Waist Tied to Increased Risk of Diabetes, A Teaching Affiliate of Harvard Medical School, http:healthlibrary.brighamandwomens.orgRelatedItems6,665409 , diakses tanggal 12 Mei 2012. Canadian Guidelines for Body Weight Classification in Adults, 2003, Health Canada Publications Centre, Canada, pp: 15 Cartier, Amelie, 2010, The Inflammatory Profile Associated with Abdominal Obesity, CMR journal, 32, pp: 15-16. Chan, dkk., 2003, Waist Circumference, Waist-to-hip Ratio and Body Mass Index as Predictors of Adipose Tissue Compartments in Men, Q J Med 2003, 96, pp: 445. Chehrei, A., Sadrnia, S., Keshteli, A., Daneshmand, A., Rezaei, J., 2007, Correlation of Dyslipidemia with Waist to Height Ratio, Waist Circumference, and Body Mass Index in Iranian Adults, Asia Pac J Clin Nutr 2007; 16 2, pp: 250. Chukwunonso, E., Ifeoma, I., 2012, Obesity in Young-adult Nigerians: Variations in Prevalence Determined by Anthropometry and Bioelectrical Impedance Analysis, and The Development of Body Fat Prediction Equations, International Archives of Medicine, 5 22, pp: 1. Cogill, B., 2003, Anthropometric Indicators Measurement Guide, Food and Nutrition Technical Assistance Project, Washington, D.C., pp. 9, 72-73. Dahlan, M. Sopiyudin, 2012, Statistik untuk Kedokteran dan Kesehatan, Deskriptif, Bivariat, dan Multivariat Dilengkapi Aplikasi dengan Menggunakan SPSS, Edisi 5, Salemba Medika, Jakarta, pp: 62-75, 170- 175 Dalton, M., Cameron, A.J., Zimmet, P.Z., Shaw, J.E., Jolley, D., Dunstan, D.W., et al., 2003, Waist Circumference, Waist-Hip Ratio and Body Mass Index and Their Correlation With Cardiovascular Disease Risk Factors in Australian Adults, Journal of Internal Medicine, 254, 556, 560. Departemen Kesehatan Republik Indonesia, 2008, Pedoman Pengendalian Diabetes Melitus dan Penyakit Metabolik, Direktorat Pengendalian Penyakit Tidak Menular, Direktorat Jenderal Pengendalian Penyakit dan Penyehatan Lingkungan, pp: 13. Despres, J., Lemieux, I., 2006, Abdominal Obesity and Metabolic Syndrome, Nature, 444, pp: 881-882. Dev, Nirmitha and Sara Rani Marcus, 2012, High Sensitive C-reactive Protein, An Independent and Early Novel Inflammatory Marker in Healthy Obese Women, Biomedical Research 2012; 23 1, pp: 75-76. Direktorat Bina Pelayanan Penunjang Medik, 2011, Uji Fungsi Alat Kimia Klinis dan Hematologi, Departemen Kesehatan Republik Indonesia, Jakarta, pp. 2. Dobbelsteyn, dkk., 2001, A Comparative Evaluation of Waist Circumference, Waist-to-Hip Ratio and Body Mass Index as Indicators of Cardiovascular Risk Factors, The Canadian Heart Health Survey, International Journal of Obesity, 255, pp. 652-661. Dugdale, 2011, Glucose Test-Blood, http:www.nlm.nih.govmedlineplusencyarticle003482.htm , U.S National Library of Medicine, NIH, diakses tanggal 10 Mei 2012. Edmundson, Ann, 2012, Type 2 Diabetes Risk Factors, http:diabetes.webmd.comguiderisk-diabetes , diakses tanggal 7 Desember 2012. Ehtisham, S., Hattersley, A.T., Dunger, D.B., Barrett, T.G., 2004, First UK Survey of Paediatric Type 2 Diabetes and MODY, Arch Dis Child, 89, pp: 526-527. Eid, W.E, 2011, Obesity and Type 2 Diabetes Mellitus in South Dakota: Focused Insight Into Prevalence, Physiology and Treatment, South Dakota Medicine, pp: 69. El Hafez, F., Hadhoud, K., Saad, M., Salem, H., 2011, Waist Circumference in Metabolic Syndrome in The Egyption Population, Journal of American Science, 7 12, pp: 1261. Esmaillzadeh, A., Mirmiran, P., Azizi, F., 2004, Waist-to-hip Ratio is a Better Screening Measure for Cardiovascular Risk Factors than Other Anthropometric Indicators in Tehranian Adult Men, International Journal of Obesity, 28, pp. 1328. Garber AJ, Handelsman Y, Einhorn D, Bergman DA, Bloomgarden Z, Fonseca V, et al., 2008, Diagnosis and Management of Prediabetes in the Continuum of Hyperglycemia—When Do the Risks of Diabetes Begin? A Consensus Statement from the American College of Endocrinology and the American Association of Clinical Endocrinologists, Endocr Pract.,147, pp: 933-46. Graham, Elizabeth, 2011, The Prevalence of Impaired Type 2 Fasting Blood Glucose Concentrations among College-aged Individuals, Thesis, 33, Georgia Southern University, Georgia. Gupta, R., Rastogi, P., Sarna, M., Gupta, VP., Sharma, SK., Kothari, K., 2007, Body-Mass Index, Waist-Size, Waist-Hip Ratio and Cardiovascular Risk Factors in Urban Subjects, J Assoc Physicians India 2007; 55, pp: 623-625. Hollmann, M., Runnebaum, B., Gerhard, I.,1997, Impact of waist–hip-ratio and body-mass-index on hormonal and metabolic parameters in young, obese women, International Journal of Obesity, 21, pp. 476–483. Humayun, Anjum, Shah, Arbab Sher, 2010, Comparison of Body Mass Index and Waist Circumference in Predicting Incident Diabetes, Pak J Physiol 2010, 61, pp.48. Hussain, A., Hydrie, M.Z.I., Clausen, B., Asghar, S., 2011, Type 2 Diabetes and Obesity: A Review, Journal of Diabetology 2010; 2, pp 1-4. Huxley, R., Mendis, S., Zheleznyakov, E., Reddy, S., dan Chan, J., 2010, Body Mass Index, Waist Circumference and Waist:Hip Ratio as Predictors of Cardiovascular Risk – A Review of the Literature, European Journal of Clinical Nutrition, 64, 16-20. Hwang, M., Chung, W., Gallagher, D., Kim, D., Shin, H., Song, M., 2008, How Useful is Waist Circumference for Assessment of Abdominal Obesity in Korean Pre-menopausal Women during Weight-loss?, Asia Pac J Clin Nutr, 172, pp: 232. International Chair on Cardiometabolic Risk, 2011, WHR, Health Risk, and Intra- abdominal Fat, http:www.myhealthywaist.orgevaluating-cmrclinical- toolswaist-to-hip-ratiopage2index.htmlEbookPage, diakses tanggal 10 Mei 2012. International Diabetes Federation, 2006, Metabolic Syndrome, The IDF Consensus Worldwide Definition of The Metabolic Syndrome, Belgium, pp. 10. ISPAD guidelines, 2012, Making a Diagnosis of Monogenic Diabetes, http:www.diabetesgenes.orgcontentmaking-diagnosis-mody , diakses tanggal 13 Januari 2013. Jenkins, G., 2011, Health Tools : Waist-to-Hip Ratio, http:www.bbc.co.ukhealthtoolship_to_waisthip_to_waist.shtml , diakses tanggal 9 Mei, 2012. Kato, M., Takahaski, Y., Inoue, M., Tsugane, S., Kadowaki, T., Noda, M., 2008, Comparisons between Anthropometric Indices for Predicting The Metabolic Syndrome in Japanese, Asia Pac J Clin Nutr, 172, pp: 226. Katzmarzyk, P., Janssen, I., Ross, R., Church, T., Blair, S., 2006, The Importance of Waist Circumference in The Definition of Metabolic Syndrome, Diabetes Care, 29 2, pp: 407. Klein, S., Allison, D., Heymsfield, S., Kelley, D., Leibel, R., Nonas, C., et al., 2007, Waist Circumference and Cardiometabolic Risk: A Consensus Statement from Shaping America’s Health: Association for Weight Management and Obesity Prevention; NAASO, The Obesity Society; The American Society for Nutrition; and The American Diabetes Association, AM J Clin Nutr 2007; 85, pp: 1199. de Koning, L., Merchant, A.T., Pogue, J., dan Anand, S.S., 2007, Waist Circumference and Waist-to-Hip Ratio As Predictors of Cardiovascular Events: Meta-Regression Analysis of Prospective Studies, European Heart Journal, 28, 850-854. Kopelman P., 2000, Obesity as a medical problem, Nature, 404, 2000, pp. 636. Lee, M., Wu, Y., Fried, S., 2012, Adipose Tissue Heterogeneity: Implication of Depot Differences in Adipose Tissue for Obesity Complications, Review, Elsevier, United States. Lipoeto, N.I., Yerizel, E., Edward, E.Y.Z., dan Widuri, I., 2007, Hubungan Antara Nilai Antropometri dengan Kadar Glukosa Darah, Skripsi, 7-11, Fakultas Kedokteran Universitas Andalas, Sumatra Barat. Liu, Y., Tong, G., Tong, W., Lu, L., dan Qin, X., 2011, Can Body Mass Index, Waist Circumference, Waist-Hip Ratio and Waist-Height Ratio Predict The Presence of Multiple Metabolic Risk Factors in Chinese Subjects?, BMC Public Health, 11, 1-5. Look For Diagnosis, 2009, Abdominal Fat Adipose Tissue, Abdominal, http:www.lookfordiagnosis.commesh_info.php?term=Abdominal+Fatla ng=1 , diakses tanggal 25 Desember 2012. Marjani, Abdoljalal, Waist Circumference, Body Mass Index, Hip Circumference and Waist-To-Hip Ratio in Type 2 Diabetes Patients in Gorgan, Iran, , Journal of Clinical and Diagnostic Research, 52, pp. 202. Massage, L., 2006, The Metabolic Syndrome, Body Metabolism Institute, Australia, pp: 1. McKinley Health Center, 2006, Waist Circumference, University of Illinois at Urbana-Champaign, pp.1. Mukhopadhyay, Ashish, Bhadra, Mithu, and Bose, Kaushik, 2005, Human Obesity : A Major Health Burden, Human Ecology Special Issues, 13, pp. 2. National Cholesterol Education Program NCEP, 2002, Third Report of The National Cholesterol Education Program NCEP Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults Adult Treatment Panel III, Final Report, NIH, pp: 27. National Health and Nutrition Examination Survey, 2007, Anthropometry Procedures Manual, CDC, USA, pp. 1-1 – 1-3. National Heart, Lung, and Blood Institute Obesity Education Initiative, 2000, The Practical Guide: Identification, Evaluation, and Treatment of Overweight and Obesity in Adults, National Institutes of Health, USA, pp. 9, 13. National Health Survey Data, 2008, Trends in Weight Gain by Age, Obesity in Australia, pp: 10. National Institutes of Health, 2012, Glucose test-blood, 2012, Medline Plus, A Service of The U.S. National Library of Medicine, http:www.nlm.nih.govmedlineplusencyarticle003482.htm , diakses tanggal 1 November 2012. National Obesity Forum, 2006, Waist Circumference, http:www.nationalobesityforum.org.ukhealthcare-professionals- mainmenu-155assessment-mainmenu-168171-waist-circumference.html , diakses tanggal 10 November 2012. NHLBI, 2012, According to Waist Circumference, Guidelines on Overweight and Obesity: Electronic Textbook, http:www.nhlbi.nih.govguidelines obesitye_txtbktxgd4142.htm, diakses tanggal 1 November 2012. Notoatmodjo, S., 2002, Metodologi Penelitian Kesehatan, Rineka Cipta, Jakarta, pp. 89, 145-148. Ohnishi, Saitoh, Takagi, Katoh, Chiba, Akasaka et al., 2006, Incidence of Type 2 Diabetes in Individuals With Central Obesity in a Rural Japanese Population, Diabetes Care, 29 5, pp: 1128. Patil, S., Sukumaran, S., Bhate, A., Mukherji, A., dan Chandrakar, S., 2012, Correlation of Blood Sugar with Waist Circumference and Body Mass Index in an Indian Population, Global Journal of Pharmacology, 6 1, pp: 10. Pinkney J., 2002, Prevention and Cure of Type 2 Diabetes, BMJ 2002, 325, pp: 232–3. Pongsatha, S., Morakot, N., Sangchun, K., Chaovisitsaree, S., 2012, Correlation Between Waist Circumference and Other Factors in Menopausal Women in Thailand, Menopause Clinic, Health, 4 2012, pp. 62-63. Ramachandran, A., Snehalatha, C., Shetty, A.S., Nanditha, A., 2012, Trends in Prevalence of Diabetes in Asian Countries, World J Diabetes, 3 6, pp: 112. Riskesdas, 2007, Laporan Hasil Riset Kesehatan Dasar, Badan Penelitian dan Pengembangan Kesehatan, Departemen Kesehatan Republik Indonesia, Jakarta. Riskesdas, 2007, Tahun 2030 Prevalensi Diabetes Melitus di Indonesia Mencapai 21,3 Juta Orang, http:www.depkes.go.idindex.phpberitapress- release414-tahun-2030-prevalensi-diabetes-melitus-di-indonesia- mencapai-213-juta-orang.html , diakses tanggal 13 Desember 2012. Rodrigues, L., 2011, What Do Men Really Look for in Women?, http:www.learnbodylanguage.orgbody_language_courting.html , diakses pada 10 Mei 2012. Rossner, S. ,2002, Obesity: the disease of the 21st century, International Journal of Obesity, 26, pp. 2-4 Salford Diabetes Care, 2012, What is Impaired Glucose Regulation?, http:www.salforddiabetescare.co.ukindex2.php?nav_id=461 , diakses tanggal 14 Desember 2012. Sastroasmoro, S. dan Ismael, S., 2010, Dasar-dasar Metodologi Penelitian Klinis, Sagung Seto, Jakarta, pp. 88. Seidell, J., Perusse, J., Bouchard, C., 2001, Waist and Hip Circumferences Have Independent and Opposite Effects on Cardiovascular Disease Risk Factors: The Quebec Family Study, Am J Clin Nutr 2001, 74, pp: 315. Shah A., Bhandary S., Malik SL, Risal P., Koju R., 2009, Waist Circumference and Waist-hip Ratio as Predictors of Type 2 Diabetes Mellitus in the Nepalese Population of Kavre District, Nepal Medical College Journal : NCMJ 2009, 114, pp: 261-267. Shen, W., Punyanitya, M., Chen, J., Gallagher, D., Jeanine, A., Pi-Sunyer, X., et al., 2006, Waist Circumference Correlates with Metabolic Syndrome Indicators Better than Percentage Fat, Obesity, 144, pp: 732. Shields, B.M., Hicks, S., Shepherd, M.H., Colclough, K., Hattersley, A.T., Ellard, S., 2010, Maturity-Onset Diabetes of The Young MODY: How Many Cases are We Missing?, Diabetologia, pp: 2507. Shirey, Katherine, 2011, Comparisons of Waist Circumference,Waist-to-hip Ratio, and Body Mass Index and Their Associations with Type 2 Diabetes in Rural and Urban India, Thesis, University of Maryland, pp: 37. Singh, Sunita, 2011, The Genetics of Type 2 Diabetes Mellitus: A Review, Journal of Scientific Research, 55, pp: 36. Soetiarto, F., Roselinda, dan Suhardi, 2010, Hubungan Diabetes Mellitus Dengan Obesitas Berdasarkan Indeks Massa Tubuh dan Lingkar Pinggang Data Riskesdas 2007, Laporan Penelitian, Pusat Penelitian dan Pengembangan Biomedis dan Farmasi, Jakarta. Soewondo, P. dan Pramono, L.A., 2011, Prevalence, Characteristics, and Predictors of Pre-diabetes in Indonesia, Med J Indones 2011, 20 4, pp: 283-285. Spiegel, M. dan Stephens, L., 2007, Statistik, edisi ketiga, diterjemahkan oleh Kastawan, W. dan Harmein, I., 150, Erlangga, Jakarta. Sudoyo cit Ashary, Rizki, 2010, Hubungan Obesitas dengan Kadar Glukosa Darah pada Lansia di Wilayah Kerja Puskesmas Aren Jaya Bekasi Periode Januari-Agustus 2010, Thesis, Universitas Pembangunan Nasional Veteran, Jakarta. The Australian Handbook for General Practitioners, 2007, Diabetes, pp: 5-6. The Global Diabetes Community, 2010, What Affects Blood Sugar Levels, http:www.diabetes.co.ukblood-glucosewhat-affects-blood-glucose- levels.html , diakses tanggal 12 November 2012. The Global Diabetes Community, 2012, Diabetes MODY, http:www.diabetes.co.ukdiabetes_mody.html , diakses tanggal 6 Desember 2012. Thevenod, Frank, 2008, Pathophysiology of Diabetes Mellitus Type 2: Roles of Obesity, Insulin Resistance and β-Cell Disfunction, Diabetes and Cancer, Epidemiological Evidence and Molecular Links, Front Diabetes, 19, pp: 2- 6. Vazquez et al., 2007, Comparison of Body Mass Index, Waist Circumference, and WaistHip Ratio in Predicting Incident Diabetes: A Meta-Analysis, Epidemiologic Reviews, pp. 115-116. Virtual Medical Centre, 2009, Assessing Central Obesity: Waist to Hip Ratio, http:www.virtualmedicalcentre.comhealth-investigationassessing- central-obesity-waist-to-hip-ratio73 , diakses tanggal 25 Desember 2012. Virtual Medical Centre, 2012, Diabetes Mellitus Type 2 non-insulin dependent, mature age onset, http:www.virtualmedicalcentre.comdiseasesdiabetes-mellitus-type-2- non-insulin-dependent-mature-age-onset826 , diakses tanggal 9 Desember 2012. Wang, Z. dan Hoy, W.E., 2004, Waist Circumference, Body Mass Index, Hip Circumference and Waist-to-Hip Ratio as Predictors of Cardiovascular Disease in Aboriginal People, European Journal of Clinical Nutrition, 58, 888-893. Wajchenberg, L. B., 2000, Subcutaneous and Visceral Adipose Tissue: Their Relation to the Metabolic Syndrome, Endocrine Reviews, 216, 697–738. Wild, S., Gojka, R., Green, A., Sicree, R., and King, H., 2004, Global Prevalence of Diabetes, Diabetes Care, 27 5, pp: 1047, 1049. World Health Organization, 2008, Waist Circumference and Waist-Hip Ratio: Report of A WHO Expert Consultation, WHO, Geneva, pp. 5-15, 20, 27. Zhu, et al., 2002, Waist Circumference and Obesity-associated Risk Factors Among Whites in the Third National Health and Nutrition Examination Survey: Clinical Action Thresholds, Am J Clin Nutr 2002, 76, pp. 743. 71 LAMPIRAN Lampiran 1. Surat Ijin Penelitian Lampiran 2. Ethical Clearance Lampiran 3. Informed Consent Lampiran 4. Surat Peminjaman Ruangan Lampiran 5. Leaflet A. Halaman depan

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