Gastroduodenal Bleeding and Perforation in Diabetic Patients with Metabolic Syndrome (The Results of a 15-Year Observation of City Residents with Intensive Urbanization)

  • Marat IMASHEV JSC 'Astana Medical University', Astana, Kazakhstan
  • Roman FURSOV JSC 'Astana Medical University', Astana, Kazakhstan
  • Alexandr FURSOV JSC 'Astana Medical University', Astana, Kazakhstan
  • Bagdat IMASHEVA JSC 'Astana Medical University', Astana, Kazakhstan
  • Roman FURSOV JSC 'Astana Medical University', Astana, Kazakhstan
  • Yerzhan KUSPAEV JSC 'Astana Medical University', Astana, Kazakhstan
  • Timofei KOVALENKO JSC 'Astana Medical University', Astana, Kazakhstan
  • Alishan ISMAILOV JSC 'Astana Medical University', Astana, Kazakhstan
  • Aigul ABDULDAYEVA JSC 'Astana Medical University', Astana, Kazakhstan
  • Irina VOLCHKOVA JSC 'Astana Medical University', Astana, Kazakhstan
Metabolic syndrome, Gastroduodenal bleeding, Diabetes mellitus


Background: The prevalence of bleeding and perforation against the diabetes mellitus, obesity and metabolic syndrome (MetS) is studied not sufficiently.
Methods: The period of collecting the material was 15 years (2003-2017). The observation analysis was conducted for the patients at polyclinics observations, by the doctors of first-aid, in the surgical departments of the Astana City, Kazakhstan. The number of first-aid visits to patients, the medical cards of the patients with gastroduodenal perforation (GDP) and gastroduodenal bleeding (GDB) were analyzed.
Results: The rate of annual growth of indices of overall morbidity Rgm=1.0%, obesity in combination with diabetes was Ro=1.7%; and morbidity with metabolic syndrome was Rm=3.1%. The diagnosis of GDP was revealed in 0.63 men with MetS for every 100000 urban people. The diagnosis of GDB was registered in 2.12 men for 100000 urban people. The index of the annual growth in patients with MetS had the tendency to the growth (Rms=3.1%).
Conclusion: The high medical and social significance of diseases of the digestive system among the adult population in Kazakhstan is determined by the annual increase in the incidence rate and a clear decrease in the quality of life of such patients, which necessitates the search for scientifically based ways to improve medical care for this population.


1. Lau JY, Sung J, Hill C, Henderson C et al (2011). Systematic review of the epidemi-ology of complicated peptic ulcer disease: incidence, recurrence, risk factors and mortality. Digestion, 84(2):102-13.
2. Thomsen RW, Riis A, Christensen S et al (2006). Diabetes and 30-Day Mortality from Peptic Ulcer Bleeding and Perfora-tion. Diabetes Care, 29:805-810.
3. Charlson M, Pompei P, Ales KL, MacKenzie CR (1987). A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis, 40(5):373-383.
4. Kaplan M, Feinstein A (1974). The im-portance of classifying initial comorbidity in evaluating the outcome of diabetes mellitus. J Chronic Dis, 27(7-8):387–404.
5. Forrest JA, Finlayson ND, Shearman DJ (1974). Endoscopy in gastrointestinal bleeding. Lancet, 304(7877):394–397.
6. Anagnostopoulos G, Yao K, Kaye P et al (2007). High-resolution magnification en-doscopy can reliably identify normal gas-tric mucosa, Helicobacter pylori-associated gastritis, and gastric atrophy. Endoscopy, 39(3): 202-207.
7. Committee on Statistics RK. Operational data:
8. Igisinov N, Baltakayeva A (2011). Spatial as-sessment of morbidity in obesity in Ka-zakhstan. The young scientist. 2(2):153-156.
9. Frezza E, Wachtel M, Ewing B (2006). The impact of morbid obesity on the state economy: an initial evaluation. Surg Obes Relat Dis, 2(5): 504-8.
10. Excess body weight and obesity in Kazakh-stan. Bulletin of the Kazakh Academy of Nutrition, 2014-8 p.
11. Fursov R, Ospanov O, Fursov A (2017). Prevalence of obesity in Kazakhstan. AMJ, 10(11):916–920.
12. Lydia Kaduka, Yeri Kombe, Eucharia Kenya et al (2012). Prevalence of Metabolic Syn-drome among an Urban Population in Kenya. Diabetes Care,35(4): 887-893.
13. Rotem Refaeli, Gabriel Chodick, Seada Haj et al (2018) Relationships of H. pylori in-fection and its related gastroduodenal morbidity with metabolic syndrome: a large cross-sectional study. Scientific Re-ports, 8:4088.
14. Rapoport S, Il'nitskiĭ A, Proshchaev K et al (2014). Peculiarities of the strategy for the treatment of elderly patients with duode-nal ulcer and concomitant metabolic syn-drome. KlinMed (Mosk), 92(4):35-40.
15. Miller J, Kaylor M, Johannsson M et al (2014). Prevalence of metabolic syn-drome and individual criterion in US adolescents: 2001-2010 National Health and Nutrition Examination Survey. Metab Syndr Relat Disord, 12(10):527-32.
16. Hye Soon, Sang Yeoup, Seon Mee et al (2006). Prevalence of the Metabolic Syn-drome among Korean Adults According to the Criteria of the International Diabe-tes Federation. Diabetes Care,29(4):933-934.
17. Kin Tong, Vishalkumar G (2017). Perforat-ed peptic ulcer - an update. World J Gas-trointest Surg, 9(1):1-12.
18. Peng Y, Leu H, Luo J et al (2013). Diabetes is an independent risk factor for peptic ulcer bleeding: a nationwide population-based cohort study. J Gastroenterol Hepa-tol,28(8):1295-1299.
How to Cite
IMASHEV M, FURSOV R, FURSOV A, IMASHEVA B, FURSOV R, KUSPAEV Y, KOVALENKO T, ISMAILOV A, ABDULDAYEVA A, VOLCHKOVA I. Gastroduodenal Bleeding and Perforation in Diabetic Patients with Metabolic Syndrome (The Results of a 15-Year Observation of City Residents with Intensive Urbanization). Iran J Public Health. 48(10):1786-1793.
Original Article(s)