# The role of hepatocyte growth factor in the relationship between body fat distribution and plasma markers of glucose metabolism: a cross-sectional study

## TL;DR

This study explores how body fat distribution affects glucose metabolism and finds that hepatocyte growth factor (HGF) may partially explain the link, especially for central obesity.

## Contribution

The study identifies HGF as a potential mediator linking central obesity to impaired glucose regulation.

## Key findings

- Central obesity measures like waist circumference and waist-to-hip ratio showed stronger associations with glucose levels than general obesity measures.
- HGF mediated 7.0% to 9.1% of the effect of obesity measures on two-hour glucose levels.
- No significant associations were found with HbA1c after adjusting for multiple testing.

## Abstract

Obesity, particularly central adiposity, is a major risk factor for impaired glucose metabolism and type 2 diabetes. The biological mechanisms linking body fat distribution to glucose regulation remain incompletely understood. Therefore, we investigated the associations between body fat distribution and plasma markers of glucose metabolism in a population-based sample and examined the mediating role of hepatocyte growth factor (HGF) in this connection.

The analysis was based on data from 238 participants of the MEGA study (German acronym for metabolic health study Augsburg) conducted between 2018 and 2021. Anthropometric measurements and a body composition analysis via bioelectrical impedance analysis (BIA) were conducted. HGF was measured from EDTA plasma based on the Proximity Extension Assay (Olink inflammation panel). Multivariable linear regression models were chosen to examine the associations between standardized anthropometric and BIA measurements and the outcome variables in non-diabetic individuals. Obesity measures included body mass index (BMI), waist circumference (WC), visceral adipose tissue (VAT), and waist-to-hip ratio (WHR), relative fat mass (RFMV), and absolute fat mass (AFMV). The outcome variables included fasting glucose, two-hour OGTT glucose, and HbA1c concentrations. Mediation effects of HGF between obesity measures and glucose parameters were assessed.

The observed positive associations between obesity measures and glucose metabolism were stronger for variables that are indicative of central obesity (WC, WHR, VAT), when compared to indices of general obesity (BMI, RFMV, AFMV). Fasting glucose showed the strongest positive association with WC (β = 5.10 mg/dL per one standard deviation increase; 95% CI 1.86–5.77). For two-hour plasma glucose, the strongest associations were observed with WHR (β = 21.00; 95% CI 14.57–27.44). HGF mediated between 7.0% and 9.1% of the total effects with two-hour glucose levels but not the associations with the other outcomes. No associations were found with HbA1c levels after accounting for multiple testing.

These findings suggest HGF may contribute to the metabolic effects of different obesity measures on post-load glucose regulation, providing insights into obesity-related glucose dysregulation and potential targets for early intervention. However, the causal role of HGF remains unproven; further studies on the exact pathophysiological mechanisms are necessary.

The online version contains supplementary material available at 10.1186/s13098-026-02096-1.