PIK3CA and hyperinsulinism: Other hormonal actions that are less or not affected by insulin resistance and may even be upregulated with the concomitant hyperinsulinemia include upregulation of PI3K-AKT dependent lipogenesis in hepatocytes and of the mechanistic target of rapamycin complex 1 (mTORC1) activity, the latter resulting in increased protein synthesis and impaired autophagy (91–95).