CARTPT encodes the cocaine- and amphetamine-regulated transcript prepropeptide, which functions as a multifaceted regulatory peptide with roles in metabolism, bone development, and neural signaling. In pancreatic islets, CART increases insulin secretion, reduces glucagon secretion, and protects beta cells against apoptosis while promoting proliferation, with expression levels elevated in Type 2 diabetes patients 1. During skeletal development, CARTPT expression is normally suppressed by the chr5 remodeling protein ATRX, and aberrant CARTPT upregulation impairs osteoclast differentiation by decreasing the RANKL/OPG ratio 2. The gene shows significant interactions with dietary quality indices, affecting metabolic parameters including glucose homeostasis, insulin sensitivity, and lipid profiles in obese individuals 34. Genetic variants in CARTPT, particularly rs2239670, mediate metabolic syndrome risk through glycemic index pathways 5. In cardiovascular disease, CARTPT-expressing smooth muscle cells are enriched in male thoracic aortic aneurysms, where CART promotes osteochondrogenic differentiation and vascular calcification 6. Additionally, CARTPT plays a role in addiction-related behaviors, with epigenetic modifications at the CARTPT locus influencing cocaine memory acquisition and extinction 7.