66

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LAMPIRAN

Lampiran 1

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Lampiran 2

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Lampiran 3

PERNYATAAN KESEDIAAN MENJADI SUBJEK PENELITIAN

(INFORMED CONSENT)

Yang bertanda tangan di bawah ini, saya :

Nama :

Umur/TTL :

Alamat :

No. Handphone :

Bersedia dan mau berpartisipasi menjadi subjek penelitian yang berjudul

“Hubungan antara Indeks Massa Tubuh (IMT) dengan Nilai Lemak Viseral (Studi
Kasus pada Mahasiswa Kedokteran Undip )” yang dilakukan oleh:

Nama :Adhitya Pradana

Instansi :Program Studi Fakultas Kedokteran Universitas

Diponegoro Semarang

Demikian pernyataan ini saya buat dengan sesungguhnya tanpa ada

paksaan dari siapapun.

Mengetahui Semarang, 2014

Peneliti Subjek penelitian

(Adhitya Pradana) ( )

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Lampiran 4

Penjelasan mengenai penelitian dengan judul:

HUBUNGAN ANTARA INDEKS MASSA TUBUH (IMT) DENGAN NILAI

LEMAK VISERAL

(Studi kasus pada mahasiswa kedokteran Undip)

Saya (Adhitya Pradana) sedang melakukan penelitian dengan judul

“Hubungan Antara Indeks Massa Tubuh (IMT) dengan Nilai Lemak Viseral
(Studi kasus pada mahasiswa kedokteran Undip)”, maka saya sebagai peneliti
memohon kesediaan Saudara/Saudari untuk menjadi subjek penelitian dalam
kegiatan penelitian ini. Penelitian ini bertujuan untuk mencari dan menganalisis
hubungan antara IMT dengan nilai lemak viseral pada mahasiswa kedokteran
Undip.

Metode penelitian

Apabila Saudara/Saudari setuju berpartisipasi dalam penelitian ini, saya

akan melakukan beberapa pengukuran diantaranya :

1. Pengisisan data subjek penelitian.

2. Pengukuran lemak viseral menggunakan Tanita BC-601 yang berbasis
metode bioelectrical impedance analysis (BIA).
3. Indeks massa tubuh (IMT) melalui pengukuran berat badan dan tinggi
badan.
4. Pengisian kuesioner meliputi kebiasaan merokok, kebiasaan konsumsi
alkolhol, kebiasaan konsumsi makanan berlemak dan aktifitas
fisik(olahraga).
5. Waktu pemerikssaan kurang lebih 15 menit.

Manfaat yang akan diperoleh adalah dapat mengetahui hubungan antara

IMT dengan nilai lemak viseral, sehingga dapat digunakan sebagai informasi
mengenai IMT sebagai indikator untuk prediktor lemak viseral, serta sebagai
landasan untuk penelitian selanjutnya mengenai lemak viseral. Tidak ada efek
samping dan risiko yang merugikan pada pemeriksaan penelitian ini.

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Semua keterangan yang diperoleh dari penelitian ini akan diperlakukan

secara rahasia. Saudara berhak menolak ikut serta dalam penelitian ini dan berhak
mengundurkan diri selama penelitian berlangsung. Selama penelitian Saudara
tidak dibebani biaya apapun, tetapi harus mengisi surat persetujuan mengikuti
penelitian.

Peneliti,

(Adhitya Pradana)

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Lampiran 5

KUESIONER

HUBUNGAN ANTARA INDEKS MASSA TUBUH (IMT) DENGAN NILAI

LEMAK VISERAL

( Studi Kasus Pada Mahasiswa Kedokteran Undip )

Identitas subjek penelitian

1. Nama :
2. Jenis kelamin :
3. Umur :

Data pengukuran Antropometri

1. Tinggi badan :
2. Berat badan :
3. IMT :
4. Nilai lemak viseral :

Data kelengkapan

1. Apakah anda perokok? Ya / Tidak

2. Berapa batang rokok sehari yang dihabiskan? Sebutkan: ...............
3. Apakah rutin melakukan aktivitas seperti olahraga? Ya / Kadang / Tidak
4. Berapa sering olahraga perminggu?
5. Berapa menit setiap kali melakukan olahraga?

Kuesioner Kebiasaan konsumsi alkohol

Berapa Kali Konsumsi Per

>1 x 1x 4-6 x / 3x/ 1-2 x / < 1x / Tidak
sehari sehari minggu minggu minggu minggu pernah

Alkohol

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Kuesioner Frekuensi Makan

Makanan Berapa Kali Konsumsi Per

berlemak >1 x 1x 4-6 x / 3x/ 1-2 x / < 1x / Tidak
sehari sehari minggu minggu minggu minggu pernah
Jeroan
(usus,
babat,
paru)
Daging
ayam
dengan
kulit
Telur
ayam
Susu full
cream
Keju
Alpukat
Minyak
goreng
Minyak
ikan
Santan
Minyak
sayur
Mentega/
margarin
Daging
kerbau/
sapi
Daging
kambing
Telur
bebek
Daging
bebek
Lain-lain
.................

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Lampiran 6

BUKU PETUNJUK INNER SCAN TANITA BC-601

MONITOR LEMAK TUBUH / TIMBANGAN

a. Pemrograman Umum

Alat akan menuntun anda dalam pengaturan. Tampilan akan menunjukkan

menu-menu utama dan alat akan berbunyi tiap kali langkah-langkah telah
dilaksanakan. Gunakan tombol naik atau turun (Up/down) untuk memilih
nomor data pribadi. Gunakan tombol set untuk menyimpan data.

b. Pilih nomor data pribadi

Nomor data pribadi menyimpan data-data pribadi dan gunakan tombol

naik atau turun (up/down) untuk memilih umur. Tekan set.

c. Pilih Pria atau Wanita (Male atau Female)

Pria dan Wanita. Standar atau atlet dewasa (baca definisinya dalam buku
manual)

d. Gunakan tombol naik atau turun (up/down) untuk menentukan tinggi

badan. Tekan set.
e. Alat akan berbunyi dua kali dan layar akan menampilkan data tiga kali
untuk konfirmasi pemrograman. Power kemudian akan mati secara
otomatis.
f. Lakukan pengukuran
Setelah memprogram data pribadi, anda melakukan pengukuran.
Tekan tombol tanda panah “Up” untuk mengaktifkan alat.
Tekan tombol tanda panah “Up”/Down untuk memilih nomor data pribadi.
Tekan tombol set. Alat akan menyala dan naiklah ke atas pijakan.
g. Berat tubuh akan muncul dahulu .Teruskan berdiri di atas timbangan .
Hasil pengukuran akan ditampilkan secara bergantian sebanyak 3 kali.
h. Pahami hasil pengukuran
Monitor lemak tubuh anada secara otomatis membandingkan hasil
pengukuran lemak tubuh dengan batas lemak tubuh sehat.

Peringatan

Jangan gunakan fitur pengukuran kadar lemak tubuh alat ini jika anda
sedang menggunakan alat pemacu jantung atau alat elektronik yang dicangkok
ke dalam tubuh

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Lampiran 7

 Hasil crosstabulasi

Indeks Massa Tubuh * Nilai Lemak Viseral

Crosstab

Nilai Lemak Viseral Total

Berlebih Sehat Berlebih
Indeks Massa Overweight Count 6 19 25
Tubuh Expected Count 2,5 22,5 25,0
% within Nilai
Lemak Viseral 75,0% 26,4% 31,3%
Normal Count 2 53 55
Expected Count 5,5 49,5 55,0
% within Nilai
Lemak Viseral 25,0% 73,6% 68,8%
Total Count 8 72 80
Expected Count 8,0 72,0 80,0
% within Nilai
Lemak Viseral 100,0% 100,0% 100,0%

Chi-Square Tests

Asymp. Sig. Exact Sig. Exact Sig.

Value df (2-sided) (2-sided) (1-sided)
Pearson Chi-Square 7,919(b) 1 ,005
Continuity
5,818 1 ,016
Correction(a)
Likelihood Ratio 7,276 1 ,007
Fisher's Exact Test ,010 ,010
Linear-by-Linear
Association 7,820 1 ,005
N of Valid Cases 80
a Computed only for a 2x2 table
b 1 cells (25,0%) have expected count less than 5. The minimum expected count is 2,50.

Symmetric Measures

Asymp.
Std. Approx.
Value Error(a) T(b) Approx. Sig.
Ordinal by Ordinal Gamma ,787 ,164 2,239 ,025
Spearman Correlation ,315 ,114 2,927 ,004(c)
Interval by Interval Pearson's R ,315 ,114 2,927 ,004(c)
N of Valid Cases 80
a Not assuming the null hypothesis.
b Using the asymptotic standard error assuming the null hypothesis.
c Based on normal approximation.

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Jenis kelamin * Nilai Lemak Viseral

Crosstab

Nilai Lemak Viseral Total

Berlebih Sehat Berlebih
Jenis kelamin Laki-laki Count 6 39 45
Expected Count 4,5 40,5 45,0
% within Nilai
Lemak Viseral 75,0% 54,2% 56,3%
Perempuan Count 2 33 35
Expected Count 3,5 31,5 35,0
% within Nilai
Lemak Viseral 25,0% 45,8% 43,8%
Total Count 8 72 80
Expected Count 8,0 72,0 80,0
% within Nilai
Lemak Viseral 100,0% 100,0% 100,0%

Chi-Square Tests

Asymp. Sig. Exact Sig. Exact Sig.

Value df (2-sided) (2-sided) (1-sided)
Pearson Chi-Square 1,270(b) 1 ,260
Continuity
,564 1 ,453
Correction(a)
Likelihood Ratio 1,340 1 ,247
Fisher's Exact Test ,455 ,229
Linear-by-Linear
Association 1,254 1 ,263
N of Valid Cases 80
a Computed only for a 2x2 table
b 2 cells (50,0%) have expected count less than 5. The minimum expected count is 3,50.

Symmetric Measures

Asymp.
Std. Approx.
Value Error(a) T(b) Approx. Sig.
Ordinal by Ordinal Gamma ,435 ,345 1,188 ,235
Spearman Correlation ,126 ,101 1,122 ,265(c)
Interval by Interval Pearson's R ,126 ,101 1,122 ,265(c)
N of Valid Cases 80
a Not assuming the null hypothesis.
b Using the asymptotic standard error assuming the null hypothesis.
c Based on normal approximation.

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Kebiasaan merokok * Nilai Lemak Viseral

Crosstab

Nilai Lemak Viseral Total

Berlebih Sehat Berlebih
Kebiasaan Merokok Count 2 3 5
merokok Expected Count ,5 4,5 5,0
% within Nilai
Lemak Viseral 25,0% 4,2% 6,3%
Tidak Merokok Count 6 69 75
Expected Count 7,5 67,5 75,0
% within Nilai
Lemak Viseral 75,0% 95,8% 93,8%
Total Count 8 72 80
Expected Count 8,0 72,0 80,0
% within Nilai
Lemak Viseral 100,0% 100,0% 100,0%

Chi-Square Tests

Asymp. Sig. Exact Sig. Exact Sig.

Value df (2-sided) (2-sided) (1-sided)
Pearson Chi-Square 5,333(b) 1 ,021
Continuity
2,370 1 ,124
Correction(a)
Likelihood Ratio 3,468 1 ,063
Fisher's Exact Test ,076 ,076
Linear-by-Linear
Association 5,267 1 ,022
N of Valid Cases 80
a Computed only for a 2x2 table
b 2 cells (50,0%) have expected count less than 5. The minimum expected count is ,50.

Symmetric Measures

Asymp.
Std. Approx.
Value Error(a) T(b) Approx. Sig.
Ordinal by Ordinal Gamma ,769 ,206 1,248 ,212
Spearman Correlation ,258 ,177 2,360 ,021(c)
Interval by Interval Pearson's R ,258 ,177 2,360 ,021(c)
N of Valid Cases 80
a Not assuming the null hypothesis.
b Using the asymptotic standard error assuming the null hypothesis.
c Based on normal approximation.

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Kebiasaan konsumsi makanan berlemak * Nilai Lemak

Viseral
Crosstab

Nilai Lemak Viseral Total

Berlebih Sehat Berlebih
Kebiasaan konsumsi Sering dikonsumsi Count 7 70 77
makanan berlemak Expected Count 7,7 69,3 77,0
% within Nilai
Lemak Viseral 87,5% 97,2% 96,3%
Jarang dikonsumsi Count 1 2 3
Expected Count ,3 2,7 3,0
% within Nilai
Lemak Viseral 12,5% 2,8% 3,8%
Total Count 8 72 80
Expected Count 8,0 72,0 80,0
% within Nilai
Lemak Viseral 100,0% 100,0% 100,0%

Chi-Square Tests

Asymp. Sig. Exact Sig. Exact Sig.

Value df (2-sided) (2-sided) (1-sided)
Pearson Chi-Square 1,886(b) 1 ,170
Continuity
,154 1 ,695
Correction(a)
Likelihood Ratio 1,280 1 ,258
Fisher's Exact Test ,274 ,274
Linear-by-Linear
Association 1,862 1 ,172
N of Valid Cases 80
a Computed only for a 2x2 table
b 2 cells (50,0%) have expected count less than 5. The minimum expected count is ,30.

Symmetric Measures

Asymp.
Std. Approx.
Value Error(a) T(b) Approx. Sig.
Ordinal by Ordinal Gamma -,667 ,358 -,797 ,426
Spearman Correlation -,154 ,175 -1,372 ,174(c)
Interval by Interval Pearson's R -,154 ,175 -1,372 ,174(c)
N of Valid Cases 80
a Not assuming the null hypothesis.
b Using the asymptotic standard error assuming the null hypothesis.
c Based on normal approximation.

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Aktifitas fisik * Nilai Lemak Viseral

Crosstab

Nilai Lemak Viseral Total

Berlebih Sehat Berlebih
Aktifitas Kurang Count 4 48 52
fisik Expected Count 5,2 46,8 52,0
% within Nilai
Lemak Viseral 50,0% 66,7% 65,0%
Cukup Count 4 24 28
Expected Count 2,8 25,2 28,0
% within Nilai
Lemak Viseral 50,0% 33,3% 35,0%
Total Count 8 72 80
Expected Count 8,0 72,0 80,0
% within Nilai
Lemak Viseral 100,0% 100,0% 100,0%

Chi-Square Tests

Asymp. Sig. Exact Sig. Exact Sig.

Value df (2-sided) (2-sided) (1-sided)
Pearson Chi-Square ,879(b) 1 ,348
Continuity
,299 1 ,584
Correction(a)
Likelihood Ratio ,843 1 ,359
Fisher's Exact Test ,441 ,286
Linear-by-Linear
Association ,868 1 ,351
N of Valid Cases 80
a Computed only for a 2x2 table
b 1 cells (25,0%) have expected count less than 5. The minimum expected count is 2,80.

Symmetric Measures

Asymp.
Std. Approx.
Value Error(a) T(b) Approx. Sig.
Ordinal by Ordinal Gamma -,333 ,333 -,869 ,385
Spearman Correlation -,105 ,117 -,931 ,355(c)
Interval by Interval Pearson's R -,105 ,117 -,931 ,355(c)
N of Valid Cases 80
a Not assuming the null hypothesis.
b Using the asymptotic standard error assuming the null hypothesis.
c Based on normal approximation.

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 Diskriptif nilai lemak viseral menurut jenis kelamin

Descriptives

JK Statistic Std. Error

Nilai lemak viseral Laki-laki Mean 5,78 ,676
Median 5,00
Variance 20,586
Std. Deviation 4,537
Minimum 1
Maximum 18
Range 17
Perempuan Mean 3,40 ,519
Median 3,00
Variance 9,424
Std. Deviation 3,070
Minimum 1
Maximum 13
Range 12

 Uji normalitas pada nilai lemak viseral menurut jenis kelamin

Tests of Normality

Kolmogorov-Smirnov(a) Shapiro-Wilk
JK Statistic df Sig. Statistic df Sig.
Laki-laki ,165 45 ,004 ,889 45 ,000
Perempuan ,238 35 ,000 ,750 35 ,000
a Lilliefors Significance Correction

Test of Homogeneity of Variance

Levene
Statistic df1 df2 Sig.
Nilai lemak viseral Based on Mean 6,387 1 78 ,014
Based on Median 5,959 1 78 ,017
Based on Median and with
adjusted df 5,959 1 74,323 ,017
Based on trimmed mean 6,846 1 78 ,011

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 Perbedaan Nilai lemak viseral

Uji Mann-Whitney Test

Ranks

JK N Mean Rank Sum of Ranks

Nilai lemak viseral Laki-laki 45 45,84 2063,00
Perempuan 35 33,63 1177,00
Total 80

Test Statistics(a)

Nilai lemak
viseral
Mann-Whitney U 547,000
Wilcoxon W 1177,000
Z -2,379
Asymp. Sig. (2-tailed) ,017
a Grouping Variable: JK

Frequencies
Statistics

Nilai lemak Indeks massa

viseral tubuh BR
N Valid 80 80 80
Missing 0 0 0
Mean 4,74 22,3737 ,55
Median 4,00 21,6000 ,00
Std. Deviation 4,115 4,38815 2,894
Minimum 1 16,20 0
Maximum 18 40,60 22

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 Uji Multivariat

Logistic Regression
Categorical Variables Codings

Parameter
Frequency coding

(1) (1)
Kebiasaan Merokok
5 1,000
merokok
Tidak Merokok 75 ,000
Indeks Massa Overweight
25 1,000
Tubuh
Normal 55 ,000

Classification Table(a,b)

Observed Predicted
Percentage
Nilai Lemak Viseral Correct
Berlebih Sehat Berlebih
Step 0 Nilai Lemak Viseral Berlebih 0 8 ,0
Sehat 0 72 100,0
Overall Percentage 90,0
a Constant is included in the model.
b The cut value is ,500

Variables in the Equation

B S.E. Wald df Sig. Exp(B)

Step 0 Constant 2,197 ,373 34,760 1 ,000 9,000

Variables not in the Equation

Score df Sig.
Step 0 Variables IMT(1) 7,919 1 ,005
KM(1) 5,333 1 ,021
Overall Statistics 12,649 2 ,002

Omnibus Tests of Model Coefficients

Chi-square df Sig.
Step 1 Step 10,665 2 ,005
Block 10,665 2 ,005
Model 10,665 2 ,005

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Model Summary

-2 Log Cox & Snell Nagelkerke R

Step likelihood R Square Square
1 41,348(a) ,125 ,261
a Estimation terminated at iteration number 6 because parameter estimates changed by less than
,001.

Hosmer and Lemeshow Test

Step Chi-square Df Sig.

1 ,157 1 ,692

Contingency Table for Hosmer and Lemeshow Test

Nilai Lemak Viseral = Nilai Lemak Viseral =

Berlebih Sehat Total

Observed Expected Observed Expected Observed

Step 1 1 2 2,000 3 3,000 5
2 5 4,606 18 18,394 23
3 1 1,394 51 50,606 52

Classification Table(a)

Observed Predicted
Percentage
Nilai Lemak Viseral Correct
Berlebih Sehat Berlebih
Step 1 Nilai Lemak Viseral Berlebih 1 7 12,5
Sehat 1 71 98,6
Overall Percentage 90,0
a The cut value is ,500

Variables in the Equation

B S.E. Wald df Sig. Exp(B)

Step IMT(1) -2,207 ,906 5,928 1 ,015 ,110
1(a) KM(1) -2,218 1,166 3,617 1 ,057 ,109
Constant 3,592 ,798 20,244 1 ,000 36,301
a Variable(s) entered on step 1: IMT, KM.

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Lampiran 8

Pelaksanaan penelitian

Tanita BC-601

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Lampiran 9

Biodata Mahasiswa

Nama : Adhitya Pradana

NIM : 22010110120064

Tempat/tanggal lahir : Cilacap / 4 Juli 1992

Jenis kelamin : Laki-laki

Alamat : Jl. H Agus Salim 18 Yogyakarta

Nomor Telepon :-

Nomor HP : 081392142470

e-mail : adh1tya064@yahoo.com

Riwayat Pendidikan Formal

1. SD : SD N NGABEAN I Yogyakarta

2. SMP : SMP N 8 Yogyakarta

3. SMA : SMA N 1 Yogyakarta

4. FK UNDIP : Masuk tahun 2010

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