In addition, secretions of mediators such as retinol-binding protein 4 (RBP-4), leptin, adipsin, vaspin, resistin, c-reactive protein (CRP), adiponectin, and omentin-1 promote imbalance in glucose and lipid metabolism, breaking down the insulin-sensitizing mechanisms, signal transduction, and triggering insulin resistance, ROS overproduction, energy uncoupling in mitochondria, cellular apoptosis and necrosis and reduced nitric oxide (NO) production [12,13]. Here, RBP4 is linked to Insulin resistance.