Several studies have provided evidence that ghrelin is involved in the regulation of metabolic balance. Recent data provide evidence that when studying the effects of ghrelin on energy balance, differential influences of the acylated and non-acylated forms of the peptide must be considered. Although the correlation between the two forms is good, they may be different hormones with opposite actions with non-acylated ghrelin being able to antagonize some of the effects of the acylated form. Future studies will reveal which of the two forms of ghrelin, the acylated or non-acylated forms, dominates and determines the net influence on energy balance.
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