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No cases meeting Hy's Law criteria (ALT/AST elevation greater than 3 times ULN combined with bilirubin elevation greater than 2 times ULN) have been reported

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In the case of therapy, this also increases the effective dose to patients [99]

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When NNMT activity is elevated as documented in obese adipose tissue, several cancer types, and aged skeletal muscle intracellular NAD+ availability decreases, SAM availability decreases, and downstream sirtuin activity (particularly SIRT1 and SIRT3) is reduced