A recent report found mutations in the de novo kynurenine pathway and reduced plasma levels of NAD in patients with congenital malformations. In a mouse model, the mutation not only altered the phenotype of the litters but the combination of a homozygous mutation and a niacin-free diet resulted in miscarriages.
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Penke, M., Kiess, W. Can niacin supplementation protect against congenital malformations?. Nat Rev Endocrinol 13, 630–631 (2017). https://doi.org/10.1038/nrendo.2017.133
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DOI: https://doi.org/10.1038/nrendo.2017.133