Abstract
BACKGROUND AND AIMS: Erectile dysfunction (ED) is a common condition in aging males and may be influenced by systemic inflammation. This study aimed to examine the association between the lymphocyte-to-C-reactive protein ratio (LCR), a novel inflammatory marker, and ED prevalence in the adult population of the United States. METHODS: Data were obtained from the 2001-2004 National Health and Nutrition Examination Survey (NHANES). Male participants aged ≥ 20 years with available LCR and ED data were included. Weighted univariate and multivariable logistic regression analyses were performed to assess the association between LCR and ED. Additional analyses included subgroup assessments, interaction testing, and restricted cubic spline modeling to evaluate nonlinearity. RESULTS: A total of 3952 male participants were included, with a mean LCR of 2.52 ± 0.08 and an ED prevalence of 19.47%. Higher LCR quartiles were associated with a lower prevalence of ED. After adjusting for potential confounders, individuals in the highest LCR quartile had a 37% lower risk of ED compared to those in the lowest quartile (OR: 0.63, 95% CI: 0.41-0.95; p = 0.03). Two-piece-wise regression identified an LCR threshold at 3.67. Below this value, LCR was inversely associated with ED risk (OR = 0.70; p = 0.01); above it, no significant association was observed (p = 0.88). Subgroup and interaction analyses confirmed the robustness of the association across different populations. CONCLUSIONS: LCR is a reliable, readily measurable biomarker that is independently associated with reduced ED risk. It may serve as a promising inflammatory marker for identifying individuals at lower risk of ED.