Fetuin-A is additionally responsible for promoting lipid-induced insulin resistance by the enhancement of free fatty acids binding to toll-like receptor 4 (TLR4) through an endogenous ligand function mediated by its terminal galactoside moiety, which is able to directly bind the Leu100–Gly123 and Thr493–Thr516 residues in TLR4, leading to adipose tissue inflammation and subsequent onset of insulin resistance [81]. The gene discussed is TLR4; the disease is Insulin resistance.