SIRT1 and Other metabolic disease: Moreover, it should be noted that, unlike glucose metabolism, in which four molecules of NAD are consumed, the generation of two moles of acetyl-CoA from one mole β-OHB consumes only one mole of NAD+ in the mitochondria, and the NAD+ saving allows to further stimulate the SIRT1’s obligate cofactor NAD+, rebalancing metabolic diseases [42].