Retinol-binding protein 4 in cardiovascular diseases: mechanisms and therapeutic perspectives

Cardiovascular diseases (CVDs) continue to be the leading cause of mortality worldwide, highlighting the need for enhanced diagnostic tools to enable early intervention. However, the complexity of these diseases poses significant challenges to their diagnosis and management. Therefore, a deeper understanding of CVD mechanisms and the development of novel diagnostic and therapeutic strategies are of critical importance. Retinol-binding protein 4 (RBP4), a member of the lipocalin family, is mainly secreted by the liver and adipose tissue and is widely recognized for its role in transporting retinol (vitamin A). Beyond functioning as a selective retinol carrier, growing evidence suggests that RBP4 is intricately involved in the pathogenesis of CVDs and their associated risk factors. Although numerous studies have established a link between RBP4 and the onset and progression of CVDs, the underlying mechanisms remain incompletely elucidated. This review summarizes the biological characteristics and multifunctional roles of RBP4 in CVD pathophysiology, examines its potential as a biomarker for diagnosis and prognosis, and explores its implications for developing new strategies to prevent and treat cardiovascular disorders.