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Updated: Jan 8, 2026

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Association between monocyte-to-high-density lipoprotein cholesterol ratio and total testosterone and testosterone
Hongyuan Chang1, Hao Wang1, Anmin Wang1
1Department of Andrology, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, People's Republic of China.
Background:
The monocyte-to-high-density lipoprotein cholesterol ratio (MHR), an indicator of inflammation and lipid metabolism, has demonstrated significant clinical potential. The study aims to investigate the association between the MHR and total testosterone (TT) levels, as well as testosterone deficiency (TD) risk, utilizing data from the NHANES.
Methods:
We analyzed data from 6,194 adult men from NHANES 2011-2016. Multivariate linear and logistic regression analyses were conducted to evaluate associations of MHR with TT levels and TD risk, respectively. Restricted cubic spline (RCS) analyses and subgroup analyses further assessed the robustness of our findings.
Results:
In the fully adjusted model, each unit increase in log-transformed MHR was associated with a decrease in TT (β = -47.91, 95% CI: -62.39, -33.43, P < 0.001) and an increase in TD risk (OR = 1.81, 95% CI: 1.46, 2.24, P < 0.001). RCS analysis confirmed a linear relationship, and the findings were consistent across subgroup analyses.
Conclusions:
This study showed that in the United States (US) adult men, a high MHR is linked to low TT levels and a higher TD risk. These findings suggest MHR could be a useful marker for early detection of low testosterone and TD risk, warranting further prospective research for confirmation.
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