This NAD+ elevation activates sirtuins, particularly SIRT1 in adipocytes and hepatocytes, which deacetylates and activates numerous metabolic regulatory proteins including PGC-1, a master regulator of mitochondrial biogenesis, oxidative metabolism, and thermogenesis
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That is the proposed reason it does not raise IGF-1 levels or impair insulin sensitivity in animal work, in contrast to full-length growth hormone
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Atencion Primaria 2004;34:509 (author reply 509)
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