Background The ghrelin plays an important role in the regulation of food intake and energy homeostasis.Therefore,the ghrelin receptor gene (GHSR) is an excellent candidate for studying metabolic syndrome.This study aimed to investigate whether polymorphisms in ghrelin receptor gene are associated with metabolic syndrome in Chinese population.Methods Subjects consisted of 698 patients aged 41 to 80 years,diagnosed as metabolic syndrome by International Diabetes Federation (IDF) 2005 criteria,and 762 age-and gender-matched controls.Three variants within the GHSR were selected and genotyped using polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP).Odds ratios were estimated using a case-control study design by controlling confounding factors.Results The NA genotype (rs2922126) in the promoter was associated with metabolic syndrome (OR 1.41,95%CI 1.03-1.94),increased waist circumference (OR 1.75,95%CI 1.26-2.42),and increased fast blood glucose (OR 1.49,95%CI 1.07-2.06) in women.The A/A genotype (rs509030) in the intron was associated with lower plasma high density lipoprotein in women (OR 1.37,95%CI 1.02-1.84).Conclusion The polymorphisms within GHSR might be a genetic risk factor for metabolic syndrome in women.