{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T15:01:17Z","timestamp":1780930877404,"version":"3.54.1"},"reference-count":18,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2024,1,5]],"date-time":"2024-01-05T00:00:00Z","timestamp":1704412800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005860","name":"Helsefonden","doi-asserted-by":"publisher","award":["21-B-0063"],"award-info":[{"award-number":["21-B-0063"]}],"id":[{"id":"10.13039\/501100005860","id-type":"DOI","asserted-by":"publisher"}]},{"name":"National Institute of Health","award":["1R01CA236816-01A1"],"award-info":[{"award-number":["1R01CA236816-01A1"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2023,10,26]]},"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Recent evidence supports that gynaecomastia may predict long-term morbidity, but evidence on the association with death and causes of death in males with gynaecomastia is lacking. The objective of this work is to estimate the risk of death in men diagnosed with gynaecomastia and evaluate whether this was conditional on underlying aetiologies of gynaecomastia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A nationwide register-based cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Nationwide Danish national health registries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Males were diagnosed with incident gynaecomastia (n=23\u2009429) from 1 January 1995 to 30 June 2021, and each was age and calendar matched to five randomly population-based males without gynaecomastia (n=117\u2009145).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions<\/jats:title>\n                    <jats:p>Not applicable.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcomes<\/jats:title>\n                    <jats:p>\n                      Gynaecomastia was distinguished between males\n                      <jats:italic>without<\/jats:italic>\n                      (idiopathic) and males\n                      <jats:italic>with<\/jats:italic>\n                      a known pre-existing risk factor. Cox regression models and Kaplan-Meier analyses estimated associations between gynaecomastia and death (all cause\/cause specific).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We identified a total of 16\u2009253 males with\n                      <jats:italic>idiopathic<\/jats:italic>\n                      gynaecomastia and 7176 with gynaecomastia and\n                      <jats:italic>a known pre-existing risk factor<\/jats:italic>\n                      . Of these, 1093 (6.7%) and 1501 (20.9%) died during follow-up, respectively. We detected a 37% increased risk of all-cause death in males with gynaecomastia in the\n                      <jats:italic>entire cohort<\/jats:italic>\n                      (HR 1.37; 95% CI 1.31 to 1.43). Death risk was highest in males diagnosed with gynaecomastia and a\n                      <jats:italic>known pre-existing risk factor<\/jats:italic>\n                      (HR 1.75; 95% CI 1.64 to 1.86) compared with males with\n                      <jats:italic>idiopathic<\/jats:italic>\n                      gynaecomastia (HR 1.05; 95% CI 0.98 to 1.13). Specific causes of increased death were malignant neoplasms and circulatory, pulmonary and gastrointestinal diseases. Of the latter, an over fivefold risk of death from liver disease was detected (HR 5.05; 95% CI 3.97 to 6.42).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Males diagnosed with gynaecomastia are at higher risk of death, observed mainly in males with a known pre-existing risk factor of gynaecomastia. These findings will hopefully stimulate more awareness among healthcare providers to potentially apply interventions that aid in alleviating underlying risk factors in males with this condition.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2023-076608","type":"journal-article","created":{"date-parts":[[2024,1,16]],"date-time":"2024-01-16T20:27:14Z","timestamp":1705436834000},"page":"e076608","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Is male gynaecomastia associated with an increased risk of death? A nationwide register-based cohort study"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9183-4796","authenticated-orcid":false,"given":"Elvira V","family":"Br\u00e4uner","sequence":"first","affiliation":[{"name":"Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet Juliane Marie Centre, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cecilie","family":"Uldbjerg","sequence":"additional","affiliation":[{"name":"Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet Juliane Marie Centre, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Youn-Hee","family":"Lim","sequence":"additional","affiliation":[{"name":"Department of Public Health, University of Copenhagen, Copehnagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Astrid","family":"Beck","sequence":"additional","affiliation":[{"name":"Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet Juliane Marie Centre, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Trine","family":"Hueg","sequence":"additional","affiliation":[{"name":"Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet Juliane Marie Centre, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anders","family":"Juul","sequence":"additional","affiliation":[{"name":"Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet Juliane Marie Centre, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,1,16]]},"reference":[{"key":"2025121402392629000_14.2.e076608.1","doi-asserted-by":"publisher","DOI":"10.4065\/84.11.1010"},{"key":"2025121402392629000_14.2.e076608.2","doi-asserted-by":"crossref","first-page":"778","DOI":"10.1111\/andr.12636","article-title":"EAA clinical practice guidelines-gynecomastia evaluation and management","volume":"7","author":"Kanakis","year":"2019","journal-title":"Andrology"},{"key":"2025121402392629000_14.2.e076608.3","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcp070677"},{"key":"2025121402392629000_14.2.e076608.4","doi-asserted-by":"crossref","DOI":"10.1210\/clinem\/dgaa440","article-title":"Marked increase in incident gynaecomastia: A 20-year national registry study, 1998-2017","volume":"105","author":"Koch","year":"2020","journal-title":"J Clin Endocrinol Metab"},{"key":"2025121402392629000_14.2.e076608.5","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2010-1720"},{"key":"2025121402392629000_14.2.e076608.6","doi-asserted-by":"publisher","DOI":"10.4103\/2230-8210.129104"},{"key":"2025121402392629000_14.2.e076608.7","doi-asserted-by":"crossref","DOI":"10.1155\/2019\/6718761","article-title":"Causes and metabolic consequences of gynecomastia in adult patients","volume":"2019","author":"Robeva","year":"2019","journal-title":"Int J Endocrinol"},{"key":"2025121402392629000_14.2.e076608.8","doi-asserted-by":"crossref","first-page":"e380","DOI":"10.1210\/clinem\/dgad048","article-title":"Increased morbidity in males diagnosed with gynecomastia: A nationwide register-based cohort study","volume":"108","author":"Uldbjerg","year":"2023","journal-title":"J Clin Endocrinol Metab"},{"key":"2025121402392629000_14.2.e076608.9","doi-asserted-by":"publisher","DOI":"10.2147\/CLEP.S91125"},{"key":"2025121402392629000_14.2.e076608.10","doi-asserted-by":"publisher","DOI":"10.1177\/1403494811399958"},{"key":"2025121402392629000_14.2.e076608.11","doi-asserted-by":"publisher","DOI":"10.1177\/1403494810394717"},{"key":"2025121402392629000_14.2.e076608.12","doi-asserted-by":"publisher","DOI":"10.1177\/1403494811399956"},{"key":"2025121402392629000_14.2.e076608.13","doi-asserted-by":"crossref","unstructured":"Rahhal SN , Fuqua JS . Gynecomastia: epidemiology, pathophysiology, and management. Curr.Clin.Neurol. S. N. Rahhal: Humana press (999 Riverview drive, suite 208, Totowa NJ 07512-1165, United States. 2010:189\u2013214. doi:10.1007\/978-1-59745-499-5 Available: https:\/\/doi.org\/10.1007\/978-1-59745-499-5_9","DOI":"10.1007\/978-1-59745-499-5_9"},{"key":"2025121402392629000_14.2.e076608.14","unstructured":"Patibandla S , Heaton J , Kyaw H . Spironolactone. 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