Nicotinamide Adenine Dinucleotide Augmentation in Overweight or Obese Middle-Aged and Older Adults: A Physiologic Study

Pencina KM, Valderrabano R, Wipper B, Orkaby AR, Reid KF, Storer T · The Journal of Clinical Endocrinology and Metabolism

Body weight fell 1.9 kg more than placebo (95% CI -3.3 to -0.5, p=0.008), diastolic blood pressure 7.0 mmHg more (-13.4 to -0.6, p=0.034), LDL cholesterol 18.7 mg/dL more (-31.9 to -5.6, p=0.007) and total cholesterol 26.9 mg/dL more, with non-HDL cholesterol falling too. Circulating NAD and its metabolites rose substantially and adverse events were similar between arms. Insulin sensitivity, liver and intra-abdominal fat, muscle strength, muscle fatigability, aerobic capacity and stair-climbing power did not differ from placebo. The regimen was two 500 mg tablets twice daily, chosen because earlier pharmacokinetic work put that dose above a 200 percent rise in blood NAD.

Population

Overweight or obese adults aged 45 and over (21 treated, 9 placebo)

Intervention

MIB-626 (NMN) 1,000 mg twice daily for 28 days

Comparator

Placebo

Limitations

Thirty participants, nine of them on placebo, over 28 days; the cardiometabolic findings are secondary endpoints in a physiologic study, not a powered efficacy trial, and the paper calls all its p-values nominal. Six participants were enrolled beyond the planned 24 after two dropouts and a scanner fault. The financial support statement names Metro International Biotech as the funder, with partial infrastructure support from a Pepper Center grant; the sponsor reviewed the protocol and the manuscript, and several authors are its employees, equity owners or consultants.