RBP4 and Insulin resistance: Mechanistically, these effects were shown to involve elevated gluconeogenic gene expression in liver (12), the activation of a RBP4 receptor, stimulated by retinoic acid 6 (STRA6)-mediated Janus kinase 2/signal transducer and activator of transcription 5 signaling cascade (16), and a local inflammatory response in adipose tissue (17, 18, 19, 20) as RBP4-triggered events that lead to insulin resistance (21).