AZGP1 (alpha-2-glycoprotein 1, zinc-binding) is a zinc-binding glycoprotein with MHC-I domain characteristics that functions as a pleiotropic regulator of metabolic and immune processes 1. Primarily, AZGP1 promotes lipid mobilization and metabolism in adipose tissue and regulates glucose utilization and insulin sensitivity 1. At the mechanistic level, AZGP1 modulates lipid metabolism through renal fatty acid β-oxidation pathways 2 and inhibits angiogenesis by suppressing endothelial cell proliferation and migration 3. AZGP1 also aggravates inflammatory responses by promoting macrophage M1 polarization and pyroptosis via the NLRP3/caspase-1 signaling pathway 4. Clinically, AZGP1 has significant disease relevance across multiple conditions. Serum AZGP1 levels independently predict poor overall and disease-free survival in colorectal, lung, and breast cancers, with detection performance (AUROC 0.78-0.89) exceeding traditional markers 5. AZGP1 is a component of the APASHA predictive model for stratifying metabolic-associated steatohepatitis risk in obese individuals 6. Loss of AZGP1 expression associates with castration-resistant prostate cancer progression and metastasis 3. Additionally, AZGP1 deficiency contributes to hypertension through impaired renal sodium excretion 2, while decreased AZGP1 levels correlate with subretinal fibrosis in age-related macular degeneration 7. AZGP1 also appears dysregulated in gestational diabetes and epilepsy 18.