Dealing with insulin resistance and oxido-reductive imbalance, to give those outside this field of knowledge a broader view of the issue, sirtuin 4 can play a central role as accelerating Ang II-induced pathological cardiac hypertrophy by inhibiting manganese superoxide dismutase activity and preventing hypoxia-induced apoptosis in H9c2 cardiomyoblast cells. The gene discussed is AGT; the disease is cardiac hypertrophy.