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Beyond energy metabolism, NAD+ functions as an essential substrate for three classes of enzymes: sirtuins (class III histone deacetylases involved in epigenetic regulation), PARPs (poly-ADP-ribose polymerases involved in DNA repair), and CD38/157 (ectoenzymes regulating calcium signaling)

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As prevalence of obesity increases, the importance to find innovative therapeutic options advanced, together with bariatric surgery and nutritional interventions