Blood samples obtained from medical students during an initial period of moderate stress were compared with samples obtained during more stressful examination periods with respect to serum lipoprotein and total serum cholesterol levels. An atherogenic index (Al) was calculated to represent two classes of lipoproteins determined by ultracentrifugation. In one group of 37 students the serum cholesterol level rose from an initial mean value of 191 to one of 235 mg. per 100 ml., and the Al rose from an initial value of 45 to one of 57. Similar results were found in a second group of 13 students. The increase in Al was due to a greater than 50% increase in the lower density lipoprotein fraction. It is suggested that this fraction may be the factor that relates stress to atherosclerosis and coronary artery disease.
Grundy SM, Griffin AC. RELATIONSHIP OF PERIODIC MENTAL STRESS TO SERUM LIPOPROTEIN AND CHOLESTEROL LEVELS. JAMA. 1959;171(13):1794–1796. doi:https://doi.org/10.1001/jama.1959.03010310026007
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