Conversely, IGFBP-4 associates with LRP5/6 when Wnt ligands are present, inhibiting the Wnt/β-catenin signaling pathway activation, which serves as a safeguard against ischemic injury to the myocardium.38 IH interferes with normal endothelial cells and can disrupt endothelial cell homeostasis, potentially leading to endothelial dysfunction. The gene discussed is LRP5; the disease is endothelial dysfunction.