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A theoretical multi-target strategy might combine: NAD+ for ongoing metabolic support: sirtuin activation, DNA repair, mitochondrial maintenance, nutrient sensing recalibration Epitalon for periodic telomere maintenance: cyclic telomerase activation to preserve replicative capacity and delay senescence onset This combination would address at least seven hallmarks between the two interventions

CVDs are the leading cause of death in patients with MASLD, whereas liver-related mortality is confined to patients with advanced fibrosis, with the risk rising exponentially as the fibrosis stage increases [6]