GHRL and rheumatoid arthritis: The association of anti-ghrelin immune complexes with the DAS-28 in the multivariate analysis was striking, considering the fact that serum ghrelin levels alone were not associated with the disease activity nor with other clinical biomarkers in RA (data not shown); this suggests that anti-ghrelin autoantibodies but not ghrelin, are affected by the disease activity of the patients.