title: Risk factors for dysbaric osteonecrosis.
abstract: OBJECTIVE
  Dysbaric osteonecrosis (DON) is a complication of ineffective decompression following exposure to high-pressure environments. This study was designed to determine risk factors for the occurrence of DON in divers.
  
  
  METHODS
  Fifty-six male divers received skeletal examinations by radiography to assess the occurrence of DON. A questionnaire was used to obtain clinical and diving information, including diving experience and maximum diving depth. Blood samples were collected to analyse the levels of plasminogen activator inhibitor (PAI)-1, cholesterol, triglyceride, low-density lipoprotein, very low-density lipoprotein, high-density lipoprotein, apolipoprotein A1 and apolipoprotein B.
  
  
  RESULTS
  Lesions of DON were detected in 31 of the 56 (55%) divers. Multivariate logistic regression analysis showed that high levels of PAI-1, a coagulation marker (odds ratio 4.281; P=0.0296) and great maximum diving depth (odds ratio 5.627; P=0.0231) were independent predictors of DON.
  
  
  CONCLUSIONS
  This study has shown the presence of coagulation abnormality in divers with DON. This result suggests that a pharmacological approach incorporating the use of an anticoagulant may represent a potential strategy for the prevention of DON.
authors.affiliation: Department of Orthopaedic Surgery, Kyushu Rosai Hospital, 1-3-1, Kuzuharatakamatsu, Kokuraminami-ku, Kitakyushu, 800-0296 Japan.
authors.forename: K
authors.initials: K
authors.lastname: Miyanishi
authors.forename: Y
authors.initials: Y
authors.lastname: Kamo
authors.forename: H
authors.initials: H
authors.lastname: Ihara
authors.forename: T
authors.initials: T
authors.lastname: Naka
authors.forename: M
authors.initials: M
authors.lastname: Hirakawa
authors.forename: Y
authors.initials: Y
authors.lastname: Sugioka
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D003430:Cross-Sectional Studies; D004242:Diving / Q000009:adverse effects*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000097:blood / Q000000981:diagnostic imaging / Q000209:etiology*; D010020:Osteonecrosis / Q000097:blood / Q000000981:diagnostic imaging / Q000209:etiology*; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood; D011859:Radiography; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D017395:Plasminogen Activator Inhibitor 1