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In NAD + -depleted states (e.g., aging or advanced disease), SIRT1 activation consumes residual NAD + , impairing NAD + -dependent repair enzymes such as PARPs, and increasing oxidative stress

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Senescent cells can aggravate neurodegenerative diseases, 166 cardiovascular diseases, 5,167 atherosclerosis, 168 osteoarthritis, 169 etc

A human study in healthy women did not find a significant influence on growth-hormone or prolactin secretion