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It serves as a key substrate for several enzyme families that keep cells healthy: Sirtuins (SIRTs) NAD+-dependent deacetylases that regulate metabolism, DNA repair, and stress responses Poly(ADP-ribose) polymerases (PARPs) Enzymes that detect and repair DNA damage CD38 and other NADases Proteins that consume NAD+ and regulate calcium signaling These enzymes need NAD+ to work properly, which creates a direct connection between NAD+ levels and overall health

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