Turkiye Klinikleri Journal of Health Sciences

.: ORIGINAL RESEARCH
Tip 2 Diyabetli Bireylerde Serum Kalsiyum Düzeyi ve Diyet Kalsiyum Alımı ile Kardiyometabolik Risk Faktörleri Arasındaki İlişki: Kesitsel Bir Çalışma
Association of Serum Calcium Level and Dietary Calcium Intake with Cardiometabolic Risk Factors in Patients with Type 2 Diabetes Mellitus: A Cross Sectional Study
Hatice ÖZÇALIŞKAN İLKAYa, Gülhan SAMURb
aErciyes Üniversitesi Sağlık Bilimleri Fakültesi, Beslenme ve Diyetetik Bölümü, Kayseri, Türkiye
bHacettepe Üniversitesi Sağlık Bilimleri Fakültesi, Beslenme ve Diyetetik Bölümü, Ankara, Türkiye
Turkiye Klinikleri J Health Sci. 2022;7(4):963-75
doi: 10.5336/healthsci.2022-90594
Article Language: TR
Full Text
ÖZET
Amaç: Bu çalışmada, Tip 2 diyabetli bireylerde serum kalsiyum düzeyi ve diyet kalsiyum alımı ile kardiyometabolik risk faktörleri ve ilgili parametreler arasındaki ilişkinin değerlendirilmesi amaçlanmıştır. Gereç ve Yöntemler: Çalışmaya 93'ü kadın (%78,2), 26'sı erkek (%21,8) olmak üzere toplam 119 Tip 2 diyabetli birey (medyan yaş=55 yıl) katılmıştır. Bireylere, yüz yüze görüşme yöntemi ile anket formu uygulanmıştır. Bireylerin beslenme alışkanlıkları, besin tüketim sıklıkları, 24 saatlik geriye dönük besin tüketim kayıtları, fiziksel aktivite kayıtları, antropometrik ölçüm değerleri, vücut bileşimi analizleri, biyokimyasal bulguları, kan basıncı ölçümlerine ilişkin veriler elde edilmiştir. Bulgular: Hemoglobin A1c (%) düzeyi <7 olan grupta, ≥7 olan gruba göre serum kalsiyum düzeyi anlamlı derecede yüksek iken (p<0,05); düşük yoğunluklu lipoprotein düzeyi <100 mg/dL olan grupta, ≥100 mg/dL olan gruba göre ve sistolik kan basıncı düzeyi <130 mmHg olan grupta, ≥130 mmHg olan gruba göre diyet kalsiyum alım miktarları anlamlı derecede yüksektir (her ikisi için p<0,01). Diyet kalsiyum alım düzeyi yeterli olan grupta, yetersiz olan gruba kıyasla çok düşük yoğunluklu lipoprotein kolesterol ve trigliserit konsantrasyonlarının düşüklüğü 3. modelde sınırda anlamlıdır (sırasıyla p=0,05; p=0,052). Diyet kalsiyum alım düzeyi yeterli olan grupta, yetersiz olan gruba göre sistolik kan basıncı düzeyi ilk analizde ve 1. modelde anlamlı miktarda düşüktür (her ikisi için p<0,05). Sonuç: Tip 2 diyabetli bireylerde serum kalsiyum düzeyi ve diyet kalsiyum alımı, bazı kardiyometabolik risk faktörleriyle ilişkilidir.

Anahtar Kelimeler: Tip 2 diabetes mellitus; serum kalsiyum düzeyi; diyet kalsiyum alımı; kardiyometabolik risk faktörleri
ABSTRACT
Objective: The aim of this study was to investigate the relationship between serum calcium level, dietary calcium intake, and cardiometabolic risk factors and associated parameters in patients with Type 2 diabetes mellitus (T2DM). Material and Methods: The study was conducted on a total of 119 patients with T2DM (93 women 78.2%, 26 men 21.8%; median age=55 years). A questionnaire form was applied to the individuals by face-to-face interview method. Data on individuals' nutritional habits, food consumption frequencies, 24-hour dietary recalls, physical activity records, anthropometric measurements, body composition analyzes, biochemical findings, blood pressure measurements were obtained. Results: In the group with hemoglobin A1c (%) <7, the serum calcium level was significantly higher than in the group with ≥7 (p<0.05). Dietary calcium intakes are significantly higher in the group with low-density lipoprotein cholesterol level <100 mg/dL compared to the group with ≥100 mg/dL, and in the group with systolic blood pressure level <130 mmHg compared to the group with ≥130 mmHg (for both, p<0.01). The lower very low-density lipoprotein cholesterol and triglyceride concentrations in the group with adequate dietary calcium intake compared to the group with inadequate dietary intake were borderline significant in the third model (p=0.05; p=0.052, respectively). The systolic blood pressure level was significantly lower in the group with adequate dietary calcium intake compared to the group with inadequate dietary calcium intake in the first analysis and first model (p<0.05 for both). Conclusion: Serum calcium level and dietary calcium intake are associated with some of cardiometabolic risk factors in individuals with T2DM.

Keywords: Type 2 diabetes mellitus; serum calcium level; dietary calcium intake; cardiometabolic risk factors
REFERENCES:
  1. Sasson C, Eckel R, Alger H, Bozkurt B, Carson A, Daviglus M, et al. American Heart Association Diabetes and Cardiometabolic Health Summit: Summary and Recommendations. J Am Heart Assoc. 2018;7(15):e009271. [Crossref]  [PubMed]  [PMC] 
  2. Cunha CM, Costa PRF, de Oliveira LPM, Queiroz VAO, Pitangueira JCD, Oliveira AM. Dietary patterns and cardiometabolic risk factors among adolescents: systematic review and meta-analysis. Br J Nutr. 2018;119(8):859-79. [Crossref]  [PubMed] 
  3. Drewnowski A, Rehm CD, Vieux F. Breakfast in the United States: Food and Nutrient Intakes in Relation to Diet Quality in National Health and Examination Survey 2011⁻2014. A Study from the International Breakfast Research Initiative. Nutrients. 2018;10(9):1200. [Crossref]  [PubMed]  [PMC] 
  4. Shah IU, Sameen A, Manzoor MF. Association of dietary calcium, magnesium, and vitamin D with type 2 diabetes among US adults: National health and nutrition examination survey 2007-2014-A cross‐sectional study. Food Sci Nutr. 2021;9(3):1480-90. [Crossref]  [PubMed]  [PMC] 
  5. Kong SH, Kim JH, Hong AR, Cho NH, Shin CS. Dietary calcium intake and risk of cardiovascular disease, stroke, and fracture in a population with low calcium intake. Am J Clin Nutr. 2017;106(1):27-34. [Crossref]  [PubMed] 
  6. Zhang F, Ye J, Zhu X, Wang L, Gao P, Shu G, et al. Anti-obesity effects of dietary calcium: the evidence and possible mechanisms. Int J Mol Sci. 2019;20(12):3072. [Crossref]  [PubMed]  [PMC] 
  7. Dugan CE, Fernandez ML. Effects of dairy on metabolic syndrome parameters: a review. Yale J Biol Med. 2014;87(2):135-47. [PubMed]  [PMC] 
  8. Gomes JMG, Costa JDA, Alfenas RCG. Effect of increased calcium consumption from fat-free milk in an energy-restricted diet on the metabolic syndrome and cardiometabolic outcomes in adults with type 2 diabetes mellitus: a randomised cross-over clinical trial. Br J Nutr. 2018;119(4):422-30. [Crossref]  [PubMed] 
  9. Pittas AG, Lau J, Hu FB, Dawson-Hughes B. The role of vitamin D and calcium in type 2 diabetes. A systematic review and meta-analysis. J Clin Endocrinol Metab. 2007;92(6):2017-29. [Crossref]  [PubMed]  [PMC] 
  10. Wright DC, Hucker KA, Holloszy JO, Han DH. Ca2+ and AMPK both mediate stimulation of glucose transport by muscle contractions. Diabetes. 2004;53(2):330-5. [Crossref]  [PubMed] 
  11. Mu-oz-Garach A, García-Fontana B, Mu-oz-Torres M. Vitamin D status, calcium intake and risk of developing type 2 diabetes: an unresolved issue. Nutrients. 2019;11(3):642. [Crossref]  [PubMed]  [PMC] 
  12. Akter S, Eguchi M, Kochi T, Kabe I, Nanri A, Mizoue T. Association of serum calcium and phosphate concentrations with glucose metabolism markers: the furukawa nutrition and health study. Nutrients. 2020;12(8):2344. [Crossref]  [PubMed]  [PMC] 
  13. Sun G, Vasdev S, Martin GR, Gadag V, Zhang H. Altered calcium homeostasis is correlated with abnormalities of fasting serum glucose, insulin resistance, and beta-cell function in the Newfoundland population. Diabetes. 2005;54(11):3336-9. [Crossref]  [PubMed] 
  14. Fraser A, Williams D, Lawlor DA. Associations of serum 25-hydroxyvitamin D, parathyroid hormone and calcium with cardiovascular risk factors: analysis of 3 NHANES cycles (2001-2006). PLoS One. 2010;5(11):e13882. [Crossref]  [PubMed]  [PMC] 
  15. Pushparani DS, Nirmala S. High level of serum calcium and iron influences the risk of type 2 diabetes mellitus with periodontitis. Journal of Asian Scientific Research. 2014;4(2):70-82. [Link] 
  16. Nwankwor H, Nwatu C, Okwara C, Young E, Olisaka L, Ezomike N, et al. Low serum calcium levels occur in Nigerian adults with type 2 diabetes and correlates negatively with their glycosylated hemoglobin levels: A case-control study. Nigerian Journal of Medicine. 2020;29(2):229-33. [Crossref] 
  17. Hajhashemy Z, Rouhani P, Saneei P. Dietary calcium intake in relation to type-2 diabetes and hyperglycemia in adults: A systematic review and dose-response meta-analysis of epidemiologic studies. Sci Rep. 2022;12(1):1050. [Crossref]  [PubMed]  [PMC] 
  18. Papageorgiou M, Merminod F, Ferrari S, Rizzoli R, Biver E. Associations of calcium intake and calcium from various sources with blood lipids in a population of older women and men with high calcium Intake. Nutrients. 2022;14(6):1314. [Crossref]  [PubMed]  [PMC] 
  19. Das S, Choudhuri D. Role of dietary calcium and its possible mechanism against metabolic disorders: A concise review. J Food Biochem. 2021;45(4):e13697. [Crossref]  [PubMed] 
  20. Jayedi A, Zargar MS. Dietary calcium intake and hypertension risk: a dose-response meta-analysis of prospective cohort studies. Eur J Clin Nutr. 2019;73(7):969-78. [Crossref]  [PubMed] 
  21. Ozcaliskan Ilkay H, Sahin H, Tanriverdi F, Samur G. Association between magnesium status, dietary magnesium intake, and metabolic control in patients with type 2 diabetes mellitus. J Am Coll Nutr. 2019;38(1):31-9. [Crossref]  [PubMed] 
  22. Rakıcıoğlu N, Tek Acar N, Ayaz A, Pekcan G. Yemek ve Besin Fotoğraf Kataloğu. 2. Baskı. Ankara: Ata Ofset Matbaacılık; 2009.
  23. BeBİS (Beslenme Bilgi Sistemi) Beslenme Veri Tabanı Yazılımı. İstanbul: 2004. Stuttgart, Almanya: Hohenhim Üniversitesi. Erişim Tarihi: 05.10.2022 [Link] 
  24. Institute of Medicine (US) Standing Committee on the Scientific Evaluation of Dietary Reference Intakes. Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride. Washington (DC): National Academies Press (US); 1997. [PubMed] 
  25. Human energy requirements: report of a joint FAO/ WHO/UNU Expert Consultation. Food Nutr Bull. 2005;26(1):166. [PubMed] 
  26. Baysal A, Aksoy M, Besler HT, Bozkurt N, Keçecioğlu S, Mercanlıgil, ve ark; editörler. Diyet El Kitabı. 5. baskı. Ankara: Hatiboğlu Yayınları; 2008.
  27. Physical status: The use of and interpretation of anthropometry: report of a WHO Expert Committee. Geneva (Switzerland): Office of Publications, WHO; 1995. [Link] 
  28. Waist circumference and waist-hip ratio: report of a WHO expert consultation. Geneva (Switzerland): WHO Document Production Services; 2011. [Link] 
  29. American Diabetes Association Professional Practice Committee. 10. Cardiovascular Disease and Risk Management: Standards of Medical Care in Diabetes-2022. Diabetes Care. 2022;45(Suppl 1):S144-S74. Erratum in: Diabetes Care. 2022. [Crossref]  [PubMed] 
  30. American Diabetes Association Professional Practice Committee, Draznin B, Aroda VR, Bakris G, Benson G, Brown FM, Freeman R, et al. 6. Glycemic Targets: Standards of Medical Care in Diabetes-2022. Diabetes Care. 2022;45(Suppl 1):S83-S96. [Crossref]  [PubMed] 
  31. da Silva Ferreira T, Torres MR, Sanjuliani AF. Dietary calcium intake is associated with adiposity, metabolic profile, inflammatory state and blood pressure, but not with erythrocyte intracellular calcium and endothelial function in healthy pre-menopausal women. Br J Nutr. 2013;110(6):1079-88. [Crossref]  [PubMed] 
  32. Kim J, Hwang JY, Kim KN, Choi YJ, Chang N, Huh KB. Relationship between milk and calcium intake and lipid metabolism in female patients with type 2 diabetes. Yonsei Med J. 2013;54(3):626-36. [Crossref]  [PubMed]  [PMC] 
  33. Skowrońska-Jóźwiak E, Jaworski M, Lorenc R, Karbownik-Lewińska M, Lewiński A. Low dairy calcium intake is associated with overweight and elevated blood pressure in Polish adults, notably in premenopausal women. Public Health Nutr. 2017;20(4):630-7. [Crossref]  [PubMed] 
  34. Rosanoff A. Rising Ca:Mg intake ratio from food in USA Adults: a concern? Magnes Res. 2010;23(4):S181-93. [PubMed] 
  35. Dai Q, Shu XO, Deng X, Xiang YB, Li H, Yang G, et al. Modifying effect of calcium/magnesium intake ratio and mortality: a population-based cohort study. BMJ Open. 2013;3(2):e002111. Erratum in: BMJ Open. 2013;3(5):null. [Crossref]  [PubMed]  [PMC] 

.: Up To Date

Login



Contact


Ortadoğu Reklam Tanıtım Yayıncılık Turizm Eğitim İnşaat Sanayi ve Ticaret A.Ş.

.: Address

Turkocagi Caddesi No:30 06520 Balgat / ANKARA
Phone: +90 312 286 56 56
Fax: +90 312 220 04 70
E-mail: info@turkiyeklinikleri.com

.: Manuscript Editing Department

Phone: +90 312 286 56 56/ 2
E-mail: yaziisleri@turkiyeklinikleri.com

.: English Language Redaction

Phone: +90 312 286 56 56/ 145
E-mail: tkyayindestek@turkiyeklinikleri.com

.: Marketing Sales-Project Department

Phone: +90 312 286 56 56/ 142
E-mail: reklam@turkiyeklinikleri.com

.: Subscription and Public Relations Department

Phone: +90 312 286 56 56/ 118
E-mail: abone@turkiyeklinikleri.com

.: Customer Services

Phone: +90 312 286 56 56/ 118
E-mail: satisdestek@turkiyeklinikleri.com

1. TERMS OF USE

1.1. To use the web pages with http://www.turkiyeklinikleri.com domain name or the websites reached through the sub domain names attached to the domain name (They will be collectively referred as "SITE"), please read the conditions below. If you do not accept these terms, please cease to use the "SITE." "SITE" owner reserves the right to change the information on the website, forms, contents, the "SITE," "SITE" terms of use anytime they want.

1.2. The owner of the "SITE" is Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. (From now on it is going to be referred as "Turkiye Klinikleri", shortly) and it resides at Turkocagi cad. No:30, 06520 Balgat Ankara. The services in the "SITE" are provided by "Turkiye Klinikleri."

1.3. Anyone accessing the "SITE" with or without a fee whether they are a natural person or a legal identity is considered to agree these terms of use. In this contract hereby, "Turkiye Klinikleri" may change the stated terms anytime. These changes will be published in the "SITE" periodically and they will be valid when they are published. Any natural person or legal identity benefiting from and reaching to the "SITE" are considered to be agreed to any change on hereby contract terms done by "Turkiye Klinikleri."

1.4. The "Terms of Use" hereby is published in the website with the last change on March 30th 2014 and the "SITE" is activated by enabling the access to everyone. The "Terms of Use" hereby is also a part of the any "USER Contract" was and/or will be done with the users using "Turkiye Klinikleri" services with or without a fee an inseparable.

2. DEFINITIONS

2.1. "SITE": A website offering different kind of services and context with a certain frame determined by "Turkiye Klinikleri" and it is accessible on-line on http://www.turkiyeklinikleri.com domain name and/or subdomains connected to the domain name.

2.2. USER: A natural person or a legal identity accessing to the "SITE" through online settings.

2.3. LINK: A link enabling to access to another website through the "SITE", the files, the context or through another website to the "SITE", the files and the context.

2.4. CONTEXT: Any visual, literary and auditory images published in the "Turkiye Klinikleri", "SITE" and/or any website or any accessible information, file, picture, number/figures, price, etc.

2.5. "USER CONTRACT": An electronically signed contract between a natural or a legal identity benefiting from special services "Turkiye Klinikleri" will provide and "Turkiye Klinikleri".

3. SCOPE OF THE SERVICES

3.1. "Turkiye Klinikleri" is completely free to determine the scope and quality of the services via the "SITE".

3.2. To benefit the services of "Turkiye Klinikleri" "SITE", the "USER" must deliver the features that will be specified by "Turkiye Klinikleri". "Turkiye Klinikleri" may change this necessity any time single-sided.

3.3. Not for a limited number, the services "Turkiye Klinikleri" will provide through the "SITE" for a certain price or for free are;

- Providing scientific articles, books and informative publications for health industry.

- Providing structural, statistical and editorial support to article preparation stage for scientific journals.

4. GENERAL PROVISIONS

4.1. "Turkiye Klinikleri" is completely free to determine which of the services and contents provided in the "SITE" will be charged.

4.2. People benefiting from the services provided by "Turkiye Klinikleri" and using the website can use the "SITE" only according to the law and only for personal reasons. Users have the criminal and civil liability for every process and action they take in the "SITE". Every USER agrees, declares and undertakes that they will not proceed by any function or action infringement of rights of "Turkiye Klinikleri"s and/or other third parties', they are the exclusive right holder on usage, processing, storage, made public and revealing any written, visual or auditory information reported to Turkiye Klinikleri" and/or "SITE" to the third parties. "USER" agrees and undertakes that s/he will not duplicate, copy, distribute, process, the pictures, text, visual and auditory images, video clips, files, databases, catalogs and lists within the "SITE", s/he will not be using these actions or with other ways to compete with "Turkiye Klinikleri", directly or indirectly.

4.3. The services provided and the context published within the "SITE" by third parties is not under the responsibility of "Turkiye Klinikleri", institutions collaborated with "Turkiye Klinikleri", "Turkiye Klinikleri" employee and directors, "Turkiye Klinikleri" authorized salespeople. Commitment to accuracy and legality of the published information, context, visual and auditory images provided by any third party are under the full responsibility of the third party. "Turkiye Klinikleri" does not promise and guarantee the safety, accuracy and legality of the services and context provided by a third party.

4.4. "USER"s cannot act against "Turkiye Klinikleri", other "USER"s and third parties by using the "SITE". "Turkiye Klinikleri" has no direct and/or indirect responsibility for any damage a third party suffered or will suffer regarding "USER"s actions on the "SITE" against the rules of the hereby "Terms of Use" and the law.

4.5. "USER"s accept and undertake that the information and context they provided to the "SITE" are accurate and legal. "Turkiye Klinikleri" is not liable and responsible for promising and guaranteeing the verification of the information and context transmitted to "Turkiye Klinikleri" by the "USER"s, or uploaded, changed and provided through the "SITE" by them and whether these information are safe, accurate and legal.

4.6. "USER"s agree and undertake that they will not perform any action leading to unfair competition, weakening the personal and commercial credit of "Turkiye Klinikleri" and a third party,  encroaching and attacking on personal rights within the "SITE" in accordance with the Turkish Commercial Code Law.

4.7. "Turkiye Klinikleri" reserves the right to change the services and the context within the "SITE"  anytime. "Turkiye Klinikleri" may use this right without any notification and timelessly. "USER"s have to make the changes and/or corrections "Turkiye Klinikleri" required immediately. Any changes and/or corrections that are required by "Turkiye Klinikleri", may be made by "Turkiye Klinikleri" when needed. Any harm, criminal and civil liability resulted or will result from changes and/or corrections required by "Turkiye Klinikleri" and were not made on time by the "USER"s belongs completely to the users.

4.8. "Turkiye Klinikleri" may give links through the "SITE" to other websites and/or "CONTEXT"s and/or folders that are outside of their control and owned and run by third parties. These links are provided for ease of reference only and do not hold qualification for support the respective web SITE or the admin or declaration or guarantee for the information inside. "Turkiye Klinikleri" does not hold any responsibility over the web-sites connected through the links on the "SITE", folders and context, the services or products on the websites provided through these links or their context.

4.9. "Turkiye Klinikleri" may use the information provided to them by the "USERS" through the "SITE" in line with the terms of the "PRIVACY POLICY" and "USER CONTRACT". It may process the information or classify and save them on a database. "Turkiye Klinikleri" may also use the USER's or visitor's identity, address, e-mail address, phone number, IP number, which sections of the "SITE" they visited, domain type, browser type, date and time information to provide statistical evaluation and customized services.

5. PROPRIETARY RIGHTS

5.1. The information accessed through this "SITE" or provided by the users legally and all the elements (including but not limited to design, text, image, html code and other codes) of the "SITE" (all of them will be called as studies tied to "Turkiye Klinikleri"s copyrights) belongs to "Turkiye Klinikleri". Users do not have the right to resell, process, share, distribute, display or give someone permission to access or to use the "Turkiye Klinikleri" services, "Turkiye Klinikleri" information and the products under copyright protection by "Turkiye Klinikleri". Within hereby "Terms of Use" unless explicitly permitted by "Turkiye Klinikleri" nobody can reproduce, process, distribute or produce or prepare any study from those under "Turkiye Klinikleri" copyright protection.

5.2. Within hereby "Terms of Use", "Turkiye Klinikleri" reserves the rights for "Turkiye Klinikleri" services, "Turkiye Klinikleri" information, the products associated with "Turkiye Klinikleri" copyrights, "Turkiye Klinikleri" trademarks, "Turkiye Klinikleri" trade looks or its all rights for other entity and information it has through this website unless it is explicitly authorized by "Turkiye Klinikleri".

6. CHANGES IN THE TERMS OF USE

"Turkiye Klinikleri" in its sole discretion may change the hereby "Terms of Use" anytime announcing within the "SITE". The changed terms of the hereby "Terms of Use" will become valid when they are announced. Hereby "Terms of Use" cannot be changed by unilateral declarations of users.

7. FORCE MAJEURE

"Turkiye Klinikleri" is not responsible for executing late or never of this hereby "Terms of Use", privacy policy and "USER Contract" in any situation legally taken into account as force majeure. Being late or failure of performance or non-defaulting of this and similar cases like this will not be the case from the viewpoint of "Turkiye Klinikleri", and "Turkiye Klinikleri" will not have any damage liability for these situations. "Force majeure" term will be regarded as outside of the concerned party's reasonable control and any situation that "Turkiye Klinikleri" cannot prevent even though it shows due diligence. Also, force majeure situations include but not limited to natural disasters, rebellion, war, strike, communication problems, infrastructure and internet failure, power cut and bad weather conditions.

8. LAW AND AUTHORISATION TO FOLLOW

Turkish Law will be applied in practicing, interpreting the hereby "Terms of Use" and managing the emerging legal relationships within this "Terms of Use" in case of finding element of foreignness, except for the rules of Turkish conflict of laws. Ankara Courts and Enforcement Offices are entitled in any controversy happened or may happen due to hereby contract.

9. CLOSING AND AGREEMENT

Hereby "Terms of Use" come into force when announced in the "SITE" by "Turkiye Klinikleri". The users are regarded to agree to hereby contract terms by using the "SITE". "Turkiye Klinikleri" may change the contract terms and the changes will be come into force by specifying the version number and the date of change on time it is published in the "SITE".

 

30.03.2014

Privacy Policy

We recommend you to read the terms of use below before you visit our website. In case you agree these terms, following our rules will be to your favor. Please read our Terms of Use thoroughly.

www.turkiyeklinikleri.com website belongs to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. and is designed in order to inform physicians in the field of health

www.turkiyeklinikleri.com cannot reach to user’s identity, address, service providers or other information. The users may send this information to the website through forms if they would like to. However, www.turkiyeklinikleri.com may collect your hardware and software information. The information consists of your IP address, browser type, operating system, domain name, access time, and related websites. www.turkiyeklinikleri.com cannot sell the provided user information (your name, e-mail address, home and work address, phone number) to the third parties, publish it publicly, or keep it in the website. Gathered information has a directing feature to be a source for the website’s visitor profile, reporting and promotion of the services.

www.turkiyeklinikleri.com uses the taken information:

-To enhance, improve and maintain the quality of the website

-To generate visitor’s profile and statistical data

-To determine the tendency of the visitors on using our website

-To send print publications/correspondences

-To send press releases or notifications through e-mail

-To generate a list for an event or competition

By using www.turkiyeklinikleri.com you are considered to agree that;

-Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. cannot be hold responsible for any user’s illegal and immoral behavior,

-Terms of use may change from time to time,

-It is not responsible for other websites’ contents it cannot control or the harms they may cause although it uses the connection they provided.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. may block the website to users in the following events:

-Information with wrong, incomplete, deceiving or immoral expressions is recorded to the website,

-Proclamation, advertisement, announcement, libelous expressions are used against natural person or legal identity,

-During various attacks to the website,

-Disruption of the website because of a virus.

Written, visual and audible materials of the website, including the code and the software are under protection by legal legislation.

Without the written consent of Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. the information on the website cannot be downloaded, changed, reproduced, copied, republished, posted or distributed.

All rights of the software and the design of the website belong to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. will be pleased to hear your comments about our terms of use. Please share the subjects you think may enrich our website or if there is any problem regarding our website.

info@turkiyeklinikleri.com