Ghrelin is a gastric orexigenic hormone circulation in acylated (A-Ghr) and desacylated (D-Ghr) forms. Total plasma Ghrelin (T-Ghr) is commonly inversely related to body mass and insulin resistence. Gastric by pass causes profound time-dependent changes in plasma Ghrelin profile. A marked increase in both T-and D-Ghr is only observed with further decline in BMI at 6-12 months from surgery
