Downregulation of low-density lipoprotein (LDL) receptor activity, decreased hepatic uptake of cholesterol from the circulation, reduction of T3-mediated control of sterol regulatory element-binding protein 2 (SREBP-2) - which modulates cholesterol biosynthesis through regulation of 3-hydroxy-3-methylglutaryl-coenzyme A reductase (HMG-COA redutase) activity (Duntas and Brenta, 2018) - reduced hepatic β-oxidation and insulin resistance are also associated with hypothyroidism. Here, HMGCR is linked to Insulin resistance.