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These heritable yet reversible modifications influence gene expression without altering the underlying DNA sequence, thereby modulating cellular responses to hyperglycemia and inflammatory stimuli (129, 130)

In patients with fatty liver or metabolic conditions, periodic monitoring of ALT, AST, and metabolic parameters is advisable to document clinical improvement

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Polymorphisms are also present in GSTs of the alpha class and omega class, with the isoenzymes GSTA1-1, GSTA2-2 and GSTO1-1 and GSTO2, respectively 32

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