Early indications of DN involve morphological changes in proximal tubular epithelial cells such as hypertrophy, proliferation, and epithelial–mesenchymal transition.64, 65, 66 Previous studies have revealed that the mTOR signaling pathway, a key regulatory pathway, can influence fibroblast proliferation, renal tubulointerstitial inflammation, and epithelial–mesenchymal transition under high glucose conditions.67 This evidence concerns the gene MTOR and liver dysplastic nodule.