At high substrate concentrations was PA oxidation reduced and the corresponding ASM levels (incomplete PA oxidation) increased (Fig. 1C). PA inhibited glucose oxidation was abolished when PA concentration increased from 0.8 mmol/l to 1.2 mmol/l PA (Fig. 1A). Acute changes in glucose concentrations seemed not to affect the degree of ASM accumulation. We recently showed that acute high PA concentration was followed by reduced PA oxidation [5] and [17]. The responsible mechanisms for PA mediated reduced PA oxidation are at present unknown. The inner mitochondrial membrane is impermeable to CoA compounds; acyl-CoA uptake into the mitochondria is mediated by CPT1, exchanging carnitine for CoA. The inverse Randle cycle could explain the reduced lipid oxidation, since increased MCoA concentrations can inhibit the entrance of lipids into the mitochondria at the level of CPT1. However, our finding of increased ASM with increased extracellular PA concentration indicated that this seems not to be the main mechanism at higher PA concentrations. Our observations that the complete PA oxidation rather then the incomplete PA oxidation was inhibited by high PA concentrations (Fig. 1B) and that the PA inhibition of glucose oxidation was abolished when going from 0.8 mmol/l PA to 1.2 mmol/l PA (Fig. 1A) could be explained by that increased acetyl-CoA originating from the β-oxidation inhibit β-ketoacyl CoA thiolase. This enzyme catalyzes the final reaction in β-oxidation whereby β-ketoacyl CoA is converted to acetyl-CoA. In agreement, a previous study has shown that acetyl-coA inhibited β-ketoacyl CoA thiolase [18].