To investigate the changes of serum ghrelin levels and their relationship with body mass index (BMI) ,waist-to-hip ratio(WHR) ,thyroid function, blood glucose, insulin, and insulin resistance parameters in different thyroid functional status. The fasting serum ghrelin, insulin, glucose, and thyroid hormone levels were determined, BMI, WHR, and homeostasis model assessment for insulin resistance index (HOMA-IR) were calculated in 50 hyperthyroid and 30 hypothyroid patients at diagnosis and after normalization of thyroid function. 30 euthyroid subjects served as control. The ghrelin levels in hyperthyroid patients before treatment were lower than that in control group [(63.2±9.6) ng/L vs (80.9±13.9) ng/L,P<0.01]. Multiple regression analysis showed that HOMA-IR was an independent factor related to fasting ghrelin levels (r = -0.314, P = 0. 027). The ghrelin levels were similar in hypothyroid patients and the controls before and after the treatment. It suggests that insulin resistance might be an important factor in regulating serum ghrelin levels in different thyroid functional status.