Background: To investigate the prognostic significance of preoperative inflammatory cell-to-high-density lipoprotein cholesterol (HDL-C) ratios in patients with non-metastatic clear cell renal cell carcinoma (ccRCC) undergoing surgery. Methods: A total of 308 patients with non-metastatic ccRCC who underwent radical or partial nephrectomy between 2003 and 2012 were retrospectively enrolled. Preoperative neutrophil-to-HDL-C ratio (NHR), monocyte-to-HDL-C ratio (MHR), platelet-to-HDL-C ratio (PHR), and lymphocyte-to-HDL-C ratio (LHR) were calculated from peripheral blood tests. Time-dependent ROC analyses were performed to compare the prognostic discrimination of these markers for overall survival (OS) and cancer-specific survival (CSS). Kaplan–Meier analysis and Cox proportional hazards regression were used to evaluate survival associations. The incremental prognostic value of NHR and MHR beyond clinicopathological factors was assessed using C-index and decision curve analysis (DCA). Results: Among the four biomarkers, NHR and MHR demonstrated more consistent prognostic discrimination for OS and CSS than PHR and LHR. Patients with high NHR or high MHR had significantly worse OS and CSS (all log-rank P < 0.0001). After adjustment for age, Fuhrman grade, and T stage, both ln-NHR and ln-MHR remained independently associated with poorer OS and CSS (all P < 0.001). Bootstrap resampling demonstrated stable cutoff estimates for NHR and MHR. Incorporation of NHR or MHR into clinicopathological models improved model discrimination and net benefit; however, the incremental prognostic gain was modest. Conclusions: Preoperative NHR and MHR were independent prognostic factors for OS and CSS in patients with non-metastatic ccRCC. Although they provided additional risk stratification beyond conventional clinicopathological factors, their clinical utility requires further validation in multicenter cohorts.

Erectile dysfunction (ED) is a common disorder in men. It frequently induces anxiety, a low quality of life, and psychological problems in patients. The lipid accumulation product (LAP) indicates the accumulation of visceral fat and is calculated using waist circumference and triglyceride levels. However, the correlation between LAP and ED risk remains unclear. Data from 21,162 participants were obtained from the National Health and Nutrition Examination Survey in the United States between 2001 and 2004. Multivariate logistic regression models, restricted cubic spline analyses, and subgroup analyses were used to explore the relationship between LAP and ED risk. The analysis revealed a significant J-shaped nonlinear correlation between LAP and ED risk. The inflection point was 6.80. The LAP was negatively and positively correlated with ED risk before and after the LAP value reached 6.80, respectively. These findings suggest that maintaining the LAP within a certain range is crucial for reducing ED risk in clinical practice. Subgroup analysis supported consistency in all study cohorts. A J-shaped relationship was observed between baseline LAP levels and ED risk in the general US population, with an inflection point of 6.80. Therefore, the LAP may be a valuable biomarker for detecting ED and may offer a new approach for the evaluation of ED.