Figure 2
From: Mammalian target of rapamycin signaling in diabetic cardiovascular disease
The role of mTOR in diabetic cardiovascular disease. Activation of mTOR promotes the secretion of insulin and increases insulin sensitivity. In contrast, rapamycin reduces insulin sensitivity, reduces glucose uptake and may prevent obesity. Hyperleptinemia can occur with diabetes and activates mTOR, stimulates vascular smooth muscle cell (VSMC) proliferation, and ultimately may contribute to atherosclerosis and hypertension. High glucose and obesity stimulate the production of angiotensin II (ANG II) to result in insulin resistance and elevated vascular tension, contributing to hypertension. Elevated resistin (for resistance to insulin) levels during diabetes can increase insulin resistance and promote mTOR activity to favor the growth of cardiomyocytes and cardiac hypertrophy.