Activin A produced by epicardial adipose tissue (EAT) T2D inhibits insulin action by inducing miR-143 in cardiomyocytes via the insulin regulator oxysterol-binding protein-related protein 8 (ORP8) to inhibit the Akt pathway, thereby slowing the progression of cardiac insufficiency [43]. The gene discussed is OSBPL8; the disease is type 2 diabetes mellitus.