MALAT1 may also inhibit FOXO1-induced SIRT1 transcription [138], reduce insulin sensitivity [139, 140], promote renal fibrosis [141], and induce p53 cell signaling [142], which may indicate that MALAT1 antagonizes the functions of niacin, NAM, NMN, NR, and NAD. This evidence concerns the gene MALAT1 and renal fibrosis.