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By blocking NNMT, the compound is associated with preserved NAD+ levels and reduced fat storage, alongside improvements in cellular energy utilization and insulin sensitivity

Unlike many other vitamins, B12 is stored in the liver in substantial quantities, meaning deficiency typically develops gradually over months to years as these reserves become depleted

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Notably, the hyperglycemic and high-AGE microenvironment within the DW vasculature and surrounding tissue actively reinforces and sustains the pro-inflammatory M1 macrophage phenotype through multiple interconnected mechanisms (Yu et al., 2025)