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Zinc-alpha2-glycoprotein (ZAG) is a 41-kDa secreted protein and adipokine belonging to the MHC class I family. It is recognized for its role in regulating lipid and glucose metabolism. Initially identified as a lipid-mobilizing factor (LMF) responsible for fat loss in cancer cachexia, ZAG has emerged as a potential therapeutic candidate for metabolic disorders such as obesity and type 2 diabetes. It functions by promoting lipolysis in adipose tissue, likely through the activation of beta-3 adrenergic receptors, and improving insulin sensitivity. Recent research from the Second Affiliated Hospital of Chongqing Medical University indicates that ZAG enhances glucose metabolism and alleviates insulin resistance via the Caprin1-AKT/GSK signaling pathway.
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