ECHDC2 (enoyl-CoA hydratase domain containing 2) is a mitochondrial enzyme with catalytic activity in fatty acid beta-oxidation and lipid metabolism 1. The gene exhibits enoyl-CoA hydratase activity and possesses RNA binding capacity [GO Annotations]. In gastric cancer, ECHDC2 functions as a tumor suppressor by binding NEDD4 to promote ubiquitination and degradation of MCCC2, thereby inhibiting aerobic glycolysis and cancer cell proliferation 1. Low ECHDC2 expression correlates with poor prognosis in gastric cancer patients 1. Beyond oncology, ECHDC2 was identified as one of eight key mitochondrial genes associated with calcific aortic valve disease pathogenesis, linked to immune cell infiltration and mitochondrial dysfunction 2. In sarcopenia research, ECHDC2 emerged as a protective factor against age-related skeletal muscle degeneration, suggesting exercise exerts anti-sarcopenia effects through fatty acid oxidation regulation 3. ECHDC2 was also identified as a hub gene associated with intracranial aneurysm rupture 4 and as a component of prognostic signatures in HPV-positive oropharyngeal cancer 5 and muscle-invasive bladder cancer 6. Additionally, genetic variants in ECHDC2 correlate with differential methylation patterns and have been implicated in drug dependence susceptibility 7. These findings establish ECHDC2 as a multifunctional gene regulating metabolic and immunological processes across multiple disease contexts.