Mevalonate production is a limiting step in cholesterol synthesis. We studied the effects of insulin on plasma mevalonate concentrations during a 3-hour euglycemic hyperinsulinemic clamp study in 10 healthy males starting at 9 h a.m. after 14 h of fasting. Physiological variations in plasma mevalonate were evaluated on a different day from 9 to 12 h a.m. under saline infusion. During the clamp studies, slight but significant decreases were noted for VLDL-triglyceride and VLDL-cholesterol at 120 and 180 min (p < 0.05) and for apolipoprotein B-100 from 60min on (p < 0.05). Plasma mevalonate decreased significantly by 34 and 41% at 120 and 180 min, respectively (p < 0.001), while the mean percent decrease due to diurnal variations was 12% at 12 h a.m. In conclusion, hyperinsulinemia in the presence of euglycemia acutely decreases the circulating levels of mevalonic acid, the immediate product of HMG CoA reductase in the cholesterol pathway.

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