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doi: 10.1016/j.fertnstert.2012.06.021

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NAD+'s metabolic roles encompass several key pathways: Energy production : NAD+ regulates glycolysis, the citric acid (TCA) cycle, oxidative phosphorylation, and fatty acid oxidation by functioning as a cofactor for redox reactions Redox balance : The NAD+/NADH ratio controls flux through metabolic pathways, ensuring properly regulated cellular metabolism Mitochondrial function : NAD+ is essential for ATP synthesis through oxidative phosphorylation, where NADH donates electrons to complex I in the electron transport chain Biosynthetic processes : Through its phosphorylated form NADP+, it supports anabolic reactions and cellular antioxidant defense mechanisms NAD+ directly shapes cellular processes that maintain tissue homeostasis