ABCA6 is an ATP-binding cassette transporter localized primarily to the Golgi apparatus and basolateral hepatocyte surfaces 1, functioning as an intracellular lipid transporter responsive to cholesterol levels 1. Its expression is regulated by FoxO transcription factors 1 and suppressed by insulin-like growth factor-1 1. ABCA6 plays a critical role in chondrocyte homeostasis by regulating intracellular cholesterol efflux; ABCA6 deficiency impairs chondrogenesis and accelerates cellular senescence through cholesterol accumulation, contributing to osteoarthritis progression 2. Loss-of-function ABCA6 mutations cause familial patellar dysplasia and subsequent joint degeneration 2, with ABCA6 identified as a key biomarker in fibrocartilage chondrocytes associated with osteoarthritis pathogenesis 3. A common missense variant (rs77542162) associates with elevated LDL and total cholesterol levels in Dutch populations 4, though functional studies in rodent models show ABCA6 does not regulate lipoprotein metabolism 5. Additionally, ABCA6 variants (rs7212506) correlate with rivaroxaban-related bleeding in aged patients, suggesting roles in drug transport and metabolism 67. Lower ABCA6 expression associates with improved gastric adenocarcinoma prognosis 8.