RBP4 and obesity due to melanocortin 4 receptor deficiency: For example, astaxanthin-supplemented high-intensity training was shown to reduce adipokines and cardiovascular risk factors in men with obesity (Saeidi et al., 2023), while spirulina or Zataria multiflora supplementation alongside HIIT reduced tumor necrosis factor-alpha (TNF-α) and retinol binding protein-4 (RBP4), suggesting a systemic anti-inflammatory effect (Tayebi et al., 2018).