Effects of Vitamin B3 Derivative Nicotinamide Riboside (NR) in Bone, Skeletal Muscle and Metabolic Functions in Aging

Exclusion Criteria

• •* Subjects who participate in regular structured exercise more than 2 hours and 30 min per week or 1hour and 15 min of vigorous exercise per week.
• •* Unwilling to comply with the follow-up schedule
• •* Inability or refusal to give informed consent by the patient
• •* Subject who takes multivitamins containing vitamin B3 derivatives in a dose \> 200 mg/day
• •* Participation in another investigational drug study within 1 year of treatment
• •* Serum 25-hydroxyvitamin D \< 15 ng/ml
• •* Serum phosphorus \> 5 mg/dL
• •* Serum alkaline phosphatase 50% above normal limit
• •* Serum aspartate transaminase 50% above normal limit
• •* Serum calcium \> 10.5 mg/dL
• •* Estimated Glomerular Filtration Rate (eGFR) \< 30 mL/min Creatinine Clearance \< 50%
• •* Poorly controlled Diabetes Mellitus (HbA1c\>8)
• •* Confirmed diagnosis of Diabetes Mellitus in use of insulin
• •* Subjects presenting systolic BP\>180 mmHg or a diastolic BP\>90 mmHg on initial evaluation
• •* Previous diagnosis of liver disease
• •* Previous chronic kidney disease stages III and IV
• •* Malignancy
• •* Malabsorption syndrome
• •* Hypo- or Hyperparathyroidism
• •* Acromegaly
• •* Cushing's syndrome
• •* Hypopituitarism
• •* Severe chronic obstructive pulmonary disease
• •* Congestive heart failure
• •* Musculoskeletal disorder
• •* History of rheumatoid arthritis
• •* Previous gastric bypass surgery
• •* Clinical history of osteoporotic fracture (spine, hip, or distal forearm) within past year
• •* Extreme of BMI (≤ 18.5 kg/m2 or ≥ 40 kg/m2)
• •* History of methotrexate therapy
• •* History of denosumab therapy
• •* History of oral or inhaled corticosteroid use \> 3 months
• •* Current use of anticoagulants in general
• •* Anticonvulsant therapy (within previous year)
• •* Sodium fluoride (any history)
• •* Treatment within the past 3 years with bisphosphonates
• •* Treatment within the past 3 years with parathyroid hormone
• •* Treatment within the past 3 years with calcitonin
• •* Treatment within the past 3 years with estrogen
• •* Treatment within the past 3 years with selective estrogen receptor modulator