Hagström Group

The group has a strong focus on fatty liver disease (NAFLD) from an epidemiological and clinical perspective and conduct high-quality studies on the progression and outcomes of NAFLD. Other research interests include the epidemiology of hepatocellular carcinoma, alcohol-related liver disease, cirrhosis and aspects of public health.

About our research

The group has a strong focus on fatty liver disease (NAFLD) from an epidemiological and clinical perspective. Our main focus is on identifying risk factors and subgroups of patients with a particularly high risk of severe liver disease outcomes, such as cirrhosis and hepatocellular carcinoma. With access to both detailed long-term follow-up studies including histology data, as well as population-based register studies, we are uniquely positioned to conduct high-quality studies on the progression and outcomes of NAFLD. Other research interests include the epidemiology of hepatocellular carcinoma, alcohol-related liver disease, cirrhosis and aspects of public health. The group is composed of clinicians, epidemiologists and research nurses. We have several collaborations with other groups at KI, as well as a large national and international network.  

Ongoing studies on NAFLD and a register-based cohort of patients 

Some ongoing studies include a large-scale screening initiative for liver disease in type 2 diabetes, development of new methods to predict progression of fibrosis in NAFLD and a national, longitudinal multi-center study in Sweden evaluating new biomarkers of disease severity in NAFLD. We have also recently built a register-based cohort consisting of all patients in Sweden with a liver disease diagnosis, and several ongoing projects are using this database.

Group leader

 

Hannes Hagström

Group Leader, Associate Professor

Hannes Hagström received his MD degree from Karolinska Institutet in 2007 and is a consultant in hepatology at the Karolinska University Hospital. He defended his thesis in 2016 and is an Associate Professor in hepatology since 2019.

Current projects focus on the epidemiology of NAFLD, where Hannes has been instrumental in creating some of the globally largest cohorts and has a wide international network. Hannes is currently the Main Supervisor of five PhD students. Hannes is also responsible for the Swedish guidelines for NAFLD and is the Scientific Secretary of the Swedish Society of Gastroenterology between 2021 and 2024.

Group members

Patrik Nasr

MD, Postdoc

Patrik Nasr received his medical degree from Linköping University in 2013 and is doing a residency in internal medicine and in gastroenterology and hepatology at Linköping University Hospital. He defended his thesis "Non-Alcoholic Fatty Liver Disease: Aspects on Diagnosis and Long-term Prognosis" in 2019.

Patrik's main interests are epidemiology and non-invasive diagnosis of non-alcoholic fatty liver disease (NAFLD), as well as delineating the relationship between type 2 diabetes mellitus, cardiovascular disease and NAFLD.

Bonnie Bengtsson

MD, PhD student

Bonnie Bengtsson received her MD degree from Karolinska Institutet in 2008 and is a specialist in internal medicine since 2018. Bonnie is currently doing her residency in gastroenterology and hepatology at the Karolinska University Hospital.

Bonnie's main interest and research focus lie on liver cirrhosis and liver cancer.

Hannes Hegmar

MD, PhD-student

Hannes Hegmar received his MD degree from Karolinska Institutet in 2017 and is currently a resident physician in gastroenterology and hepatology at the Karolinska University Hospital.

His research interest is non-alcoholic fatty liver disease (NAFLD), liver cirrhosis and hepatocellular carcinoma (HCC). His PhD studies with Dr. Hannes Hagström as Main supervisor, focus on non-invasive prognostic markers in in chronic liver disease with a main focus on NAFLD.   

Andrea Lindfors

MD, PhD-student

Andrea Lindfors has a MD degree 2006 from Uppsala University. She is specialist in internal medicine since 2014 and in gastroenterology and hepatology since 2015.

Andrea has a special interest in liver cirrhosis and decompensating symptoms along with disease progression. Andrea is a PhD-student since 2021, focusing primarily on sarcopenia in patients with chronic liver disease and its role in disease progression and prognosis.

Gustav Jakobsson

Affiliated to research

Åsa Lindé

Research nurse

Åsa Lindé has long experience as a research nurse especially in nephrology. Åsa is working in the MILES group since 2020, with a focus on clinical studies in NAFLD and cirrhosis.

Emilie Toresson Grip

PhD student

Emilie Toresson Grip, holds a MSc in Economics with special focus on Health Economics from Lund University, Sweden. Emelie is currently Associate Director at Quantify Research, where she's responsible for the RWE and Analytics unit and leading retrospective Nordic register studies.

As part of her employment at Quantify Research she is an industrial PhD student at Karolinska Institutet. Her research focus lies on the epidemiology and economic burden of chronic liver disease in general and non-alcoholic fatty liver disease (NAFLD) in particular, with a special focus on risk factors and non-invasive prognostic scores for developing severe liver disease.

Axel Wester

Postdoc

Axel  Wester received his MD degree in 2018 and defended his thesis in clinical medicine in 2021 at Lund University. Currently, Axel is doing a post doc, where he uses national population-based registries to study the epidemiology of liver disease.

Ying Shang

Postdoc

Ying Shang received her medical degree in 2014 and phd in geriatric medicine in 2021. Her current work involves the risk factors and prognosis of liver disease. Ying's previous work focused on the impact of type 2 diabetes in older adults, with a special interest in cognitive impairment and dementia, physical function and survival.

Christian Lewinter

MD, PhD, affiliated to research

Christian Lewinter received his MD degree from Københavns Universitet in 2006 and is a cardiologist at the Karolinska University Hospital. Christian defended his PHD thesis at the University of York, UK in 2013. From 2014-2015 he was a postdoc at the Center for basic metabolic research (Novo Nordic Foundation) at Københavns Universitet.

Christian's main interests are heart failure and ischemic heart disease examined through epidemiological and biostatistical methods.   

Hanne Åström

MD, PhD student

Hanne Åström received her medical degree from Karolinska Institutet in 2021 and is currently working as a junior doctor in internal medicine at Södersjukhuset. Hanne’s research interest includes epidemiological aspects of chronic liver disease, with a focus on non-alcoholic fatty liver disease (NAFLD). She joined the Hagström group in 2021 and is currently under registration to become a PhD-student.

Open positions

We are always looking for talented postdocs or tentative PhD candidates with previous experience in epidemiology and biostatistics to help us improve our understanding of liver diseases.

If you are interested, contact Group Leader Hannes Hagström 

Projects

We are currently involved in >40 scientific projects. A few of the major projects are briefly outlined below.

Screening for Advanced Fibrosis due to NAFLD in persons with type 2 diabetes (SCANDIA)

This is a screening initiative where persons with type 2 diabetes that undergo retinopathy screening are also offered an examination of their liver using transient elastography. The study will examine the prevalence of NAFLD and advanced fibrosis in T2D, and study if this is a feasible way to identify patients that risk development of cirrhosis early on.

Long-term follow-up of patients with NAFLD

We have access to one of the largest cohorts globally (n>1100) of patients with biopsy-proven NAFLD. The cohort is linked to national registers, allowing for investigation of long-term outcomes. Several sub-studies are ongoing.

Fatty liver in Sweden (FLIS):

This is a multi-center cohort study at several Swedish university hospitals led by us. Patients with NAFLD are followed longitudinally for up to five years with elastography and detailed biobanking of samples.

Epidemiology of liver disease in Sweden

We have obtained register-level data on all patients with a liver disease in Sweden since 1969 and matched controls. We can thus investigate a large number of outcomes in patients with a diagnosis of any liver disease compared to the general population. A large number of projects are ongoing.

Health Outcomes and Risk Assessment in Chronic Liver Disease (HERALD)

Here we are obtaining detailed register-level data, including results from laboratory tests from all persons in Stockholm county, including detailed data from liver biopsies and elastography in a subgroup. The project will cross-link data from a large number of sources to build an extensive and detailed database on liver disease outcomes in a population-based cohort study.

Research support

We are supported by grants from several sources, including ​​​​​​independent research grants from partners in the industry and:

  • The Swedish Research Council
  • Swedish Cancer Society
  • Radiumhemmets Research Foundation
  • Region Stockholm

Selected publications

2020-2021

Administrative coding in electronic health care record-based research of NAFLD: an expert panel consensus statement.
Hagström H, Adams LA, Allen AM, Byrne CD, Chang Y, Grønbaek H, Ismail M, Jepsen P, Kanwal F, Kramer J, Lazarus JV, Long MT, Loomba R, Newsome PN, Rowe IA, Ryu S, Schattenberg JM, Serper M, Sheron N, Simon TG, Tapper EB, Wild S, Wong VW, Yilmaz Y, Zelber-Sagi S, Åberg F
Hepatology 2021 Jan;():

Repeated FIB-4 measurements can help identify individuals at risk of severe liver disease.
Hagström H, Talbäck M, Andreasson A, Walldius G, Hammar N
J Hepatol 2020 11;73(5):1023-1029

Mortality in biopsy-proven alcohol-related liver disease: a population-based nationwide cohort study of 3453 patients.
Hagström H, Thiele M, Roelstraete B, Söderling J, Ludvigsson JF
Gut 2021 Jan;70(1):170-179

Ability of Noninvasive Scoring Systems to Identify Individuals in the Population at Risk for Severe Liver Disease.
Hagström H, Talbäck M, Andreasson A, Walldius G, Hammar N
Gastroenterology 2020 01;158(1):200-214

2018-2019

Risk Factors for Severe Liver Disease in Patients With Type 2 Diabetes.
Björkström K, Franzén S, Eliasson B, Miftaraj M, Gudbjörnsdottir S, Trolle-Lagerros Y, Svensson AM, Hagström H
Clin Gastroenterol Hepatol 2019 12;17(13):2769-2775.e4

Characteristics and outcome of hepatocellular carcinoma in patients with NAFLD without cirrhosis.
Bengtsson B, Stål P, Wahlin S, Björkström NK, Hagström H
Liver Int 2019 06;39(6):1098-1108

Cardiovascular risk factors in non-alcoholic fatty liver disease.
Hagström H, Nasr P, Ekstedt M, Hammar U, Stål P, Askling J, Hultcrantz R, Kechagias S
Liver Int 2019 01;39(1):197-204

Non alcoholic fatty liver disease is an increasing indication for liver transplantation in the Nordic countries.
Holmer M, Melum E, Isoniemi H, Ericzon BG, Castedal M, Nordin A, Aagaard Schultz N, Rasmussen A, Line PD, Stål P, Bennet W, Hagström H
Liver Int 2018 11;38(11):2082-2090

Fibrosis stage but not NASH predicts mortality and time to development of severe liver disease in biopsy-proven NAFLD.
Hagström H, Nasr P, Ekstedt M, Hammar U, Stål P, Hultcrantz R, Kechagias S
J Hepatol 2017 12;67(6):1265-1273

Risk for development of severe liver disease in lean patients with nonalcoholic fatty liver disease: A long-term follow-up study.
Hagström H, Nasr P, Ekstedt M, Hammar U, Stål P, Hultcrantz R, Kechagias S
Hepatol Commun 2018 01;2(1):48-57