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Mechanistically, NNMT suppression increased adipose SAM and NAD, upregulated polyamine flux enzymes (ODC, SSAT), and altered histone methylation consistent with a shift toward oxidative metabolism [2]

3.5 Meta-analysis The included studies showed substantial heterogeneity (I 2 = 99.6%, p 0.05), supporting the conclusion of comparable efficacy and the lack of a clear doseresponse relationship

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