The exhumation of Danish astronomer Tycho Brahe (1546-1601) was performed in 2010 to verify speculative views on the cause of his death. Previous analyses of skeletal and hair remains recovered from his grave refuted the presumption that he died from poisoning. These studies also outlined the possibility that he actually died from an acute illness, echoing the rather vague and inaccurate testimony of some historical records. We performed a detailed paleopathological analysis of Tycho Brahe's skeletal remains, along with a reconstruction of his diet based on carbon and nitrogen stable isotopes analysis and an estimate of his physical status (relative body fat) based on medullar and cortical dimensions of the femoral shaft. The astronomer's remains exhibit bone changes indicative of diffuse idiopathic skeletal hyperostosis (DISH). The study further allows us to classify him as obese (100% reliability according to our decision tree designed from Danish males), and points out his rich diet (high input of animal protein and/or marine resources) and high social status. Comorbidities of DISH and obesity are reviewed, and their influence on health status is discussed. We further consider some conditions associated with metabolic syndrome as possible causes of Tycho Brahe's final symptoms (urinary retention, renal failure and coma), including diabetes, alcoholic ketoacidosis and benign prostatic hypertrophy. Although a definite and specific diagnosis cannot be established, our study points to today's civilization diseases often associated with DISH and metabolic syndrome as the possible cause of death of Tycho Brahe.

Department of Anthropology and Human Genetics Faculty of Science Charles University Prague Czech Republic

Department of Anthropology National Museum Prague Czech Republic

Department of Archaeology Durham University Durham United Kingdom

Department of Archaeology National Heritage Institute Prague Czech Republic

Department of Culture and Society Section for Medieval and Renaissance Archaeology Aarhus University Højbjerg Denmark

Department of Radiology Na Homolce Hospital Prague Czech Republic

Institute of Chemical Process Fundamentals of Czech Academy of Sciences Prague Czech Republic

Institute of Pathology 1st Faculty of Medicine Charles University and General University Hospital Prague Prague Czech Republic

Institute of Physics Chemistry and Pharmacy University of Southern Denmark Odense Denmark

Laboratory of Biological Anthropology Institute of Forensic Medicine University of Copenhagen Copenhagen Denmark

Nuclear Physics Institute of Czech Academy of Sciences Husinec Řež Czech Republic

PACEA UMR 5199 University of Bordeaux Pessac France

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