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VPS35 regulates mitochondrial fusion protein 2 (Mfn2) by controlling the transport of mitochondrial ubiquitin ligase 1 (MUL1) to the mitochondrial membrane, promoting mitochondrial fusion, which in turn increases ATP production and reduces mitophagy [105]

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The pulsatile nature of this release is clinically significant: it mimics endogenous GH secretion rhythms, preserving downstream IGF-1 production, protein synthesis, and fat oxidation without the sustained GH elevation that can impair insulin sensitivity