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Advanced research protocols also track NAD+ levels via blood assay, respiratory exchange ratio (RER) during exercise to measure substrate utilization, and adiponectin levels as a marker of metabolic health

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NAD + degradation NAD + consumption As a co-substrate important to various postsynthesis modifications of fundamental macromolecules, NAD + can be cleaved by NAD + -consuming enzymes including PARPs, sirtuins, CD38 and SARM1 to generate NAM and ADP-ribose (ADPR) (Fig

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