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In addition, a number of factors, such as neurotransmitters, other hormones, and metabolic intermediates (amino acids, glucose, and free fatty acids), mainly acting at on the hypothalamic or pituitary level, or both, but also on the pituitary, can modify, both acutely and chronically, the pattern of GH release

For instance, changes in DNA methylation patterns, histone modifications, as well as circulating miRNA expression alterations may affect critical biological pathways, thereby influencing health outcomes in NS workers 220

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Science 275 , 964967 (1997)