The nicotinamide metabolic pathway was in an abnormal activation state in OSCC tumor tissues. (a) Heatmap shows differential metabolites in tumor and adjacent normal tissues of OSCC, n = 40. (b) Nicotinamide N-methyltransferase (NNMT)-mediated methyl transfer from S-adenosyl-L-methionine (SAM) to nicotinamide (NAM), forming 1-methylnicoti-namide (MNA) and S-adenosyl-L-homocysteine (SAH). (c–e) The relative metabolic levels of NAM, SAM and SAH in tumors and normal tissues of OSCC patients, respectively, n = 40. **** represents that differences were considered statistically significant with p < 0.0001.