It is also known that nicotinamide prevents AMPK activation by inhibiting SIRT1 phosphorylation, which can lead to insulin resistance and reduced GLUT4 (29, 35); therefore, it is likely that RSV has modified the expression of SNARE proteins through increased GLUT4 transport to the muscle cell surface by activating SIRT1 and improving insulin sensitivity. The gene discussed is INS; the disease is Insulin resistance.