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In children with ESAM, differential methylation has been observed at loci linked with metabolic dysfunctionassociated fatty liver disease (MAFLD), including NDUFS1 (involved in mitochondrial complex I function), PHLDA1 (associated with adipogenesis), NFE2L1 (essential for hepatic proteasome function), and SLC2A4 (encoding an insulin-sensitive glucose transporter) [9, 137,138,139,140]

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