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Background  Several studies have demonstrated suppressed levels of acylated (AG) and unacylated ghrelin (UAG) in patients with type 2 diabetes. However, the role of these hormones in type 1 diabetes has not been extensively studied. This study assessed the relationship between AG and UAG levels and body composition in patients with type 1 diabetes.    Methods  We selected eighteen patients with type 1 diabetes and divided them into two groups: non-obese (BMI < 25 kg/m 2 ) and overweight (BMI ≥ 25 kg/m 2 ). Demographics, parameters of body composition and serum parameters including AG and UAG, were assessed.    Results  The patients with a BMI ≥ 25 kg/m 2  were older and had a longer duration of diabetes. AG and UAG levels were not significantly different between non-obese and overweight groups (mean AG non-obese ± SD: 44.5 ± 29.4 pg/ml and mean UAG non-obese 42.4 ± 20.7 pg/ml vs mean AG overweight ± SD: 46.1 ± 29.6 pg/ml and mean UAG overweight 47.2 ± 18.2 pg/ml). AG/UAG ratios did not discriminate between these groups. There was a positive association of insuline dose/kg bodyweight with BMI (r 2  = 0.45, p = 0.002).    Conclusions  Surprisingly, unlike non-diabetics and in T2D, we did not observe a difference in plasma levels of AG and UAG between normal weight and overweight adult type 1 diabetics. However, we did observe a positive correlation between BMI and insuline dose/kg bodyweight, suggesting that exogenous insulin is more important than the ghrelin system in the development of obesity in type 1 diabetes.

Overweight and obesity in type 1 diabetes is not associated with higher ghrelin concentrations