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SIRT1, an NAD + -dependent deacetylase, regulates multiple critical processes, including lipid metabolism reprogramming, insulin signaling, oxidative stress response, autophagy, and immune balance, forming a regulatory network that spans metabolic, inflammatory, immune, and stress-related pathways
However, several large-scale clinical trials to prevent diseases such as T2DM, CVD, and cancer with antioxidant vitamin supplements failed to demonstrate the expected prevention and, in some cases, led to worsening of the biomarkers
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They typically resolve or become manageable within 2-4 weeks at each new dose level