GHRL and metabolic disease: The circulating levels of obestatin, ghrelin and obestatin /ghrelin ratio have recently been a subject of intense research in cardio-metabolic disease.12 Obestatin, a peptide hormone released from the stomach, is encoded by the pre-proghrelin gene.13,14 Ghrelin is produced predominantly by the gastrointestinal tract and involved in the regulation of energy balance.11,15 This peptide acts as an insulin secretagogue, however the exact mechanism of its action on metabolism regulation is less clear.16