SIRT1 and Hyperglycemia: Butein is a chalcone-type flavonoid [139], with antioxidant, anti-inflammatory, antiangiogenic, anticancer, and antidiabetic activities [140]. In vitro and in vivo studies show butein activates SIRT1 and suppresses p53 acetylation, protecting NP cells from apoptosis and senescence triggered by hyperglycemia. Significantly alleviates degenerative effects in diabetic IVDD rat models, where increased NP expression of SIRT1 and decreased p53 acetylation is evident [86]. Cell culture and animal model data.