
This study investigated the relationship between acylated (AcG) and unacylated ghrelin (UnG) with body weight and insulin resistance in a cohort covering a wide range of BMI. The results showed that fasting AcG and UnG were negatively correlated with BMI, while the AcG/UnG ratio was positively correlated. Insulin sensitivity was positively associated with AcG and UnG. However, in a multivariate analysis, only BMI, not insulin sensitivity, was independently linked to AcG and UnG levels. After an oral glucose tolerance test, significant changes in AcG and UnG concentrations were observed, with more pronounced AcG increases in individuals with BMI <40 kg/m². These findings suggest the potential for pharmacologic intervention in ghrelin acylation and UnG increase for obesity treatment, despite lower absolute AcG levels.
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