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Nicotinic acid may be used as an antilipemic agent, but nicotinamide does not exhibit hypolipidemic activity

The insulin-induced signalling pathway leading to S6 and initiation factor 4E binding protein 1 phosphorylation bifurcates at a rapamycin-sensitive point immediately upstream of p70s6k

doi: 10.1016/0024-3205(86)90522-9
doi: 10.1001/jamaneurol.2014.3625

More specifically, it causes the active forms to convert to cyanocobalamin, causing a functional deficiency