The HUNT Study is a large population-based health study conducted in Nord-Trøndelag County, Norway since 1984. It involves collecting extensive health and lifestyle data from questionnaires, clinical examinations, and biological samples from over 100,000 invited participants across three main surveys (HUNT1-3). This data is linked to national health registers to enable longitudinal research on disease development and risk factors. Planning is underway for a fourth survey, HUNT4, to continue expanding the study's contributions to public health research.

1. 1
The HUNT Study. www.hunt.ntnu.no
The HUNT Study
HUNT Research Centre, Norway Steinar Krokstad, Director, MD PhD
The HUNT Study. www.hunt.ntnu.no

2. 2
The HUNT Study. www.hunt.ntnu.no
Nord-Trøndelag County, Norway
24 Municipalities, 130.000 inhabitants
HUNT Research Centre, Norway Steinar Krokstad, MD PhD

3. 3
The HUNT Study. www.hunt.ntnu.no
Kilde: Statistisk
Sentralbyrå
1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2
An
0
100
200
Hjerte - karsykdommer, Nord - Trøndelag
Hjerte - karsykdommer, Norge
Kreft, Nord - Trøndelag
Kreft, Hele Norge
Lungesykdommer, Nord - Trøndelag
Lungesykdommer, Hele Norge
Lungesykdommer
HUNT – generalizability to Norway

4. 4
The HUNT Study. www.hunt.ntnu.no
HUNT –
generalizability to
Norway

5. 5
The HUNT Study. www.hunt.ntnu.no
Data collection
• Questionnaires
• Clinical measurements
• Biological material, biobanking
• Linkage to national total population registers (projects)
– The unike 11 digit personal identification number

6. 6
The HUNT Study. www.hunt.ntnu.no
Prevalence of obesity, men
HUNT1 (1984-86) HUNT2 (1995-97) HUNT3 (2006-08)

7. 7
The HUNT Study. www.hunt.ntnu.no
Adults
Team 1:
- 5 municipalities (towns)
Team 2 (buss team):
- 19 small municipalities

8. 8
The HUNT Study. www.hunt.ntnu.no
HUNT1 (1984-86)
• Is communicable TB eradicated?
– Need for a total adult population lung X-ray survey
• How is the quality of antihypertensive therapy in
primary care? (Holmen, J)
• How is the quality of diabetes therapy in primary
care? (Midthjell, K)
• Does blood pressure screening and treatment reduce
quality of life? (Moum, T)
HUNT Research Centre, Norway Steinar Krokstad, MD PhD

9. 9
The HUNT Study. www.hunt.ntnu.no

10. 10
The HUNT Study. www.hunt.ntnu.no
HUNT1
1984-86
Death reg.
31.12.2005

11. 11
The HUNT Study. www.hunt.ntnu.no
HUNT2 (1995-97)
• Wider scientific basis
• A lot of medical diciplins
• Data on a lot of diseases,
illnesses and symptoms
HUNT Research Centre, Norway Steinar Krokstad, MD PhD

12. 12
The HUNT Study. www.hunt.ntnu.no
HUNT3 (2006-08)
• Design as in HUNT2
• Data collected in 24 municipalities
• 18 research groups engaged in the planning
• New large biobank established
HUNT Research Centre, Norway Steinar Krokstad, MD PhD

13. 13
The HUNT Study. www.hunt.ntnu.no
Young-HUNT
The youth part of
the HUNT Study, Norway
• 13-19 years
• 60 schools
• One questionnaire
• Clinical measurements
• DNA
HUNT Research Centre, Norway Steinar Krokstad, MD PhD

14. 14
The HUNT Study. www.hunt.ntnu.no
The HUNT Study
Survey Material Invited Part. rate
Total population
HUNT 1 (1984-86) > 20 years 77,212 90 %
HUNT 2 (1995-97) >13 years 104,000 70 %
HUNT 3 (2006-08) >13 years 105,000 60 %
HUNT Research Centre, Norway Steinar Krokstad, MD PhD

15. 15
The HUNT Study. www.hunt.ntnu.no
0
10
20
30
40
50
60
70
80
90
%
13-15 16-19 20-29 30-39 40-49 50-59 60-69 70-79 80-89
HUNT 3
Gender
Participation in HUNT3, age dependent
HUNT Research Centre, Norway Steinar Krokstad, MD PhD

16. 16
The HUNT Study. www.hunt.ntnu.no
HUNT1 (1984-86)
Invited (aged 20+) 86 404
Participated (89.4%) 77 212
HUNT2 (1995-97)
Invited (aged 20+) 93 898
Participated (69.5%) 65 237
HUNT3 (2006-08)
Invited (aged 20+) 93 860
Participated (54.1%) 50 807
Flow chart showing the number of invited and the number of participants in the
differende cohorts in the HUNT Study. The total county population 20+ years in
Nord-Trøndelag County Norway have been invited to all the surveys.
Dead, emigrated, disappeared: 8545
Moved to other county: 4357
Dead, emigrated, disappeared or
moved to other county: 17 389
HUNT1 – 2 cohorta
Participants: 47 316
HUNT1 – 2 cohort
Participants: 47 316
HUNT1 – 2 – 3 cohortb
Participants: 27 992
HUNT2 – 3 cohortc
Participants: 37 071
HUNT1 – 2 – 3 cohort
Participants: 27 992
HUNT1 – 2 – 3 cohort
Participants: 27 992
HUNT2 – 3 cohort
Participants: 37 071
Registers
Participants can be
followed up in local
or national end-point
register, or censored
due to available
information about
death, emigration or
disappearance.

17. 17
The HUNT Study. www.hunt.ntnu.no
young-HUNT 95/97 (13-19 yrs, n=9131)
+
young-HUNT2000/01 (17-19 yrs, n=2700)
+
Norwegian Birth Register
+
HUNT I and HUNT II (adult-HUNT)
(parents, siblings, grandparents)

18. 18
The HUNT Study. www.hunt.ntnu.no
How do we do it?

19. 19
The HUNT Study. www.hunt.ntnu.no
Invitation, Q1 Pamphlet
HUNT Research Centre, Norway Steinar Krokstad, MD PhD

20. 20
The HUNT Study. www.hunt.ntnu.no
Q2
Handed over at the screening
Q3Questionnaires
HUNT 3
Q1 mailed
Men
Women
Q3 Cardiovaskular Diabetes Brestcanster
Q3 Canser prostate and colon Health services
Q3 Psoriasis Hand eczema CAM
Q3 Carnivores
HUNT Research Centre, Norway Steinar Krokstad, MD PhD

21. 21
The HUNT Study. www.hunt.ntnu.no
Photo documentation clinical examinations
Heigth Weight
BP. Pulse.
Circumferences.
Biological material.
Screening station in Verdal

22. 22
The HUNT Study. www.hunt.ntnu.no
Photo documentation clinical examinations
DTX. DEXA.
Spirometry.Screening station in Verdal

23. 23
The HUNT Study. www.hunt.ntnu.no
Photo documentation clinical examinations
Blood vessel function test
Max O2 uptake.Screening station in Verdal

24. 24
The HUNT Study. www.hunt.ntnu.no

25. 25
The HUNT Study. www.hunt.ntnu.no
EDTA plasma 1
Serum (SST)
ACD blod
for celle immortalisering
Buffy coats
Biochem. Liq. N2 -80ºC
EDTA plasma 2
Na-Heparin
HUNT 3, biological sample protocol
• Rapid cooling to + 40C, transport at + 40C, temp. log and history of every singel tube,
fractionation and alikvotation, in 36 hours
HUNT Research Centre, Norway Steinar Krokstad, MD PhD

26. 26
The HUNT Study. www.hunt.ntnu.no
Cold chain
Blood: 4 deg
Blood: Roomtemp.
Urine: - 18 deg
100.000 km over 2 years
HUNT Research Centre, Norway Steinar Krokstad, MD PhD

27. 27
The HUNT Study. www.hunt.ntnu.no
HUNT Research Centre, Norway Steinar Krokstad, MD PhD

28. 28
The HUNT Study. www.hunt.ntnu.no
HUNT Research Centre, Norway Steinar Krokstad, MD PhD

29. 29
The HUNT Study. www.hunt.ntnu.no
Fully automated sample handling, fractionation and distribution at 40 C
Cold room at 40 C
Automated distribution from vacutainer tubes to cryo tubes
HUNT Research Centre, Norway Steinar Krokstad, MD PhD

30. 30
The HUNT Study. www.hunt.ntnu.no
Buccal DNA on FTA-paper from the Young-HUNT study (10 000)
HUNT Research Centre, Norway Steinar Krokstad, MD PhD

31. 31
The HUNT Study. www.hunt.ntnu.no
HUNT1 (1984-86)
Invited (aged 20+) 86 404
Participated (89.4%) 77 212
HUNT2 (1995-97)
Invited (aged 20+) 93 898
Participated (69.5%) 65 237
HUNT3 (2006-08)
Invited (aged 20+) 93 860
Participated (54.1%) 50 807
Flow chart showing the number of invited and the number of participants in the
differende cohorts in the HUNT Study. The total county population 20+ years in
Nord-Trøndelag County Norway have been invited to all the surveys.
Dead, emigrated, disappeared: 8545
Moved to other county: 4357
Dead, emigrated, disappeared or
moved to other county: 17 389
HUNT1 – 2 cohorta
Participants: 47 316
HUNT1 – 2 cohort
Participants: 47 316
HUNT1 – 2 – 3 cohortb
Participants: 27 992
HUNT2 – 3 cohortc
Participants: 37 071
HUNT1 – 2 – 3 cohort
Participants: 27 992
HUNT1 – 2 – 3 cohort
Participants: 27 992
HUNT2 – 3 cohort
Participants: 37 071
Registers
Participants can be
followed up in local
or national end-point
register, or censored
due to available
information about
death, emigration or
disappearance.
HUNT Research Centre, Norway Steinar Krokstad, MD PhD
Research designs

32. 32
The HUNT Study. www.hunt.ntnu.no
Population registers for linkage
• National total population registers
– Family (biology/household)
– Mortality (total/cause spesific)
– Cancer Register
– National insurance data (FD-Trygd)
– Birth register (all births from 1967)
– Education DB
– Income
– Prescription DB
• Lokal hospital data/registers
– Levanger and Namsos lokal hospitals
• Cardiovascular diseases (stroke, MI)
• Fractures (hip, forearm)
• Psychiatric diseases (dementia, schizofrenia, bipolar disorders)
– University hospital (St. Olavs, Trondheim)
• Meningitis
• SAH
HUNT Research Centre, Norway Steinar Krokstad, MD PhD

33. 33
The HUNT Study. www.hunt.ntnu.no
Methodological papers
HUNT Research Centre, Norway Steinar Krokstad, MD PhD

34. 34
The HUNT Study. www.hunt.ntnu.no

35. 35
The HUNT Study. www.hunt.ntnu.no
Data access
• Protocols
• Access restricted to a specific publication plan
and for a limited time
• REC and other approvals
• Data spesifications http://www.ntnu.no/hunt/variabler
• De-identified data files

36. 36
The HUNT Study. www.hunt.ntnu.no
http://www.ntnu.no/hunt/datatilgang
Data access

37. 37
The HUNT Study. www.hunt.ntnu.no

38. 38
The HUNT Study. www.hunt.ntnu.no
Risk factor detection

39. 39
The HUNT Study. www.hunt.ntnu.no
Critical to risk factor clinical practice

40. 40
The HUNT Study. www.hunt.ntnu.no

41. 41
The HUNT Study. www.hunt.ntnu.no

42. 42
The HUNT Study. www.hunt.ntnu.no
HUNT4

43. 43
The HUNT Study. www.hunt.ntnu.no
HUNT4
• Data collection planned from 2017
• Will include the entire population of Nord-Trøndelag above 12 years
• A budget of 140 million NOK
• Requested by NTNU, Health Authorities, County Council, Health Dep., national and
international researchers
• Development of academic content well underway
• Efforts to secure funding well underway

44. 44
The HUNT Study. www.hunt.ntnu.no