这里就轮到NAD⁺出场了。很多人把NAD⁺理解成“能量”,其实并不准确。NAD⁺更像一辆能够运输电子的空车。当它在糖酵解、丙酮酸氧化、三羧酸循环中接收到电子以后,就变成还原态的NADH。NADH再把这些高能电子送入线粒体内膜上的电子传递链(Electron Transport Chain)。电子依次经过复合体I、辅酶Q、复合体III、细胞色素c、复合体IV,最终交给氧气。在这个过程中,复合体I、III和IV不断把质子泵到线粒体内膜外侧,形成一个巨大的“质子水坝”。最后,质子通过ATP合酶——复合体V流回来,就像水流推动水轮机一样,驱动:ADP + Pi → ATP。[1]这才是有氧状态下大量ATP产生的核心。根据现代生物能量学计算,一个葡萄糖完全氧化后通常可得到大约30~32个ATP,具体数值会因为胞质NADH采用不同的线粒体穿梭系统而有所不同,并不能简单理解成“人体32个、脑组织30个”。[2]
NMN也好,NR也好,AKG也好,真正值得关注的,从来不是某一个被神化的“长寿成分”。它们真正重要的意义,是帮助我们看见生命运行的底层逻辑:食物怎样进入三羧酸循环;NAD⁺怎样接受电子变成NADH;NADH怎样把电子送入线粒体呼吸链;质子梯度怎样驱动ATP合酶;AKG又怎样从一个能量代谢中间体,进一步连接表观遗传与细胞信号系统。这才是现代抗衰老科学正在发生的真正变化——我们开始从“哪里不舒服就补哪里”,走向理解细胞怎样产生能量、怎样感知环境、怎样修复和调节自身。至于我们最终能不能真正延缓人类衰老、延长健康寿命,科学还在继续给出答案。而在答案完全揭晓之前,尊重机制、尊重证据、尊重研究边界,本身就是对生命科学最大的尊重。本文用于生命科学与营养学科普,不用于疾病诊断、治疗或替代正规医疗。营养补充剂的机制依据不等同于特定产品已经获得疾病治疗、逆转衰老或延长人类寿命的临床证明。参考文献:[1]Regulation and function of the mammalian tricarboxylic acid cycle.Journal of Biological Chemistry, 2023;299(2):102838. PMID: . DOI: 10.1016/j.jbc.2022.102838.[2]Sugar for the brain: the role of glucose in physiological and pathological brain function.Trends in Neurosciences, 2013. PMID: .[3]NAD+ metabolism: pathophysiologic mechanisms and therapeutic potential.Signal Transduction and Targeted Therapy, 2020. PMID: .[4]Chronic nicotinamide riboside supplementation is well-tolerated and elevates NAD+ in healthy middle-aged and older adults.Nature Communications, 2018. PMID: . DOI: 10.1038/s41467-018-03421-7.[5]The differential impact of three different NAD+ boosters on circulatory NAD and microbial metabolism in humans.Nature Metabolism, 2026;8:62–73. PMID: . DOI: 10.1038/s42255-025-01421-8.[6]Nicotinamide mononucleotide increases muscle insulin sensitivity in prediabetic women.Science, 2021;372:1224–1229. PMID: .[7]Safety and Metabolism-Related Outcomes of Oral Nicotinamide Mononucleotide Supplementation in Adults: A Systematic Review and Meta-Analysis.Nutrients, 2026;18(14):2251. PMID: . DOI: 10.3390/nu18142251.[8]Metabolic Coordination of Cell Fate by α-Ketoglutarate-Dependent Dioxygenases.2020. PMID: 33092942;另参见Introduction: Metals in Biology: α-Ketoglutarate/Iron-Dependent Dioxygenases.PMID: .[9]The metabolite α-ketoglutarate extends lifespan by inhibiting ATP synthase and TOR.Nature, 2014;510:397–401. PMID: . DOI: 10.1038/nature13264.[10]Alpha-Ketoglutarate, an Endogenous Metabolite, Extends Lifespan and Compresses Morbidity in Aging Mice.Cell Metabolism, 2020. PMID: .[11]Astaxanthin, meclizine, mitoglitazone, pioglitazone, alpha-ketoglutarate, mifepristone, methotrexate, and atorvastatin-telmisartan do not increase lifespan in UM-HET3 mice.GeroScience, 2026;48:. PMID: . DOI: 10.1007/s11357-026-02201-2.[12]Rejuvant®, a potential life-extending compound formulation with alpha-ketoglutarate and vitamins, conferred an average 8 year reduction in biological aging…Aging, 2021;13:. PMID: . DOI: 10.18632/aging.203736.[13]Alpha-ketoglutarate supplementation and BiologicaL agE in middle-aged adults (ABLE)—intervention study protocol.GeroScience, 2023. PMID: 37217632.