A group of studies has shown that sirtuin 6 (SIRT6), which is upregulated in PTCs and associated with tumor progression, induces both the Warburg effect through activation of ROS, and EMT through upregulation of HIF-1α, which in turn upregulates the expression of SNAIL and TWIST [194,195,196].SIRT6 ↑ ⇒ ROS ↑ ⇒ HIF-1α ↑ ⇒ SNAIL, TWIST ↑ ⇒ EMT⇓PKM, GLUT1, HK2, LDHA, Eno1, PGK1, GAPDH ↑ ⇒ Warburg effect. Here, TWIST1 is linked to neoplasm.