DBI (diazepam binding inhibitor), also known as acyl-CoA binding protein (ACBP), is a multifunctional protein with dual roles in lipid metabolism and neuromodulation. As an intracellular lipid carrier, DBI binds medium- and long-chain acyl-CoA esters with high affinity and regulates fatty acid synthesis termination 1. DBI also functions as an endogenous ligand to GABA-A receptors, acting as an unconventional agonist and positive allosteric modulator at benzodiazepine binding sites, particularly affecting mechanosensitive neurons in dorsal root ganglia 23. Extracellularly, DBI is secreted through an autophagy-dependent pathway and acts as a systemic "hunger factor": elevated circulating DBI stimulates food intake and adipogenesis while suppressing autophagy 45. Clinically, elevated ACBP/DBI plasma levels associate with poor prognosis in hepatocellular carcinoma, metabolic syndrome, and Cushing's syndrome 67. DBI neutralization via antibodies, genetic knockout, or GABA-A receptor mutation alleviates liver disease, anorexia, Cushing's syndrome, and neuropathic pain 673. Thus, DBI represents both a biomarker and therapeutic target for metabolic, neoplastic, and neurological disorders.