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The monocyte/HDL ratio sets the number of monocytes in your blood against your HDL cholesterol. A high ratio may point to more inflammation and fat build-up in the blood vessel wall, and researchers are looking at whether the ratio can tell us something about a disease of the blood vessels.[1]
On this page you can read what the monocyte/HDL ratio is, what the guidelines say about a value that is too low or too high, what affects your value and which values are best to read alongside it.
Also known as: MHR, monocyte-to-HDL cholesterol ratio. At the lab: not applicable.
The monocyte/HDL ratio compares the number of monocytes in your blood with your HDL cholesterol. Monocytes are cells that are a major source of substances that drive inflammation.[1]
HDL cholesterol counters the inflammatory and oxidising side of monocytes. It slows the pull of macrophages towards the blood vessel wall, it slows the oxidation of LDL and it helps carry cholesterol away from those cells.[1]
HDL also plays a part in holding back the activation of monocytes. It also slows the production of new monocytes from their precursor cells.[1]
Inflammation and fat build-up are two core features of a long-term disease of the blood vessels. That inflammation is not only local. It can affect the whole body, with more inflammatory substances in the blood.[1]
In the blood vessel wall, macrophages clear away altered LDL. This releases inflammatory substances and forms an inflamed plaque full of cholesterol.[1]
In this way, many monocytes and little HDL cholesterol may together play a part in diseases of the heart and blood vessels. That is why the authors are looking at whether the ratio is a useful sign for predicting how these diseases develop and progress, instead of each of the two values on its own.[1]
| Level | Can point to | Who it is for |
|---|---|---|
| Many monocytes[1] | More substances that drive inflammation; may play a part in a disease of the blood vessels | As described in the review, with no fixed cut-off |
| Low HDL cholesterol[1] | Less restraint on the inflammatory side of monocytes; may play a part in diseases of the heart and blood vessels | As described in the review, with no fixed cut-off |
| High monocyte/HDL ratio[1] | May point to a greater chance that a disease of the blood vessels develops or progresses; the review looks at whether the ratio can predict this | Reported in inflammatory conditions; the source gives no fixed cut-off |
Source: a review by Ganjali and colleagues in J Cell Physiol, an overview of research into the ratio in diseases of the heart and blood vessels. The source gives no figures for a cut-off.[1]
According to the review, a high ratio may point to a greater chance that a disease of the blood vessels develops or progresses. The combination of many monocytes and little HDL cholesterol has also been reported in inflammatory conditions. The source gives no fixed cut-off.[1]
BioProfile is working on its own zones for each value, from risk to optimal. A doctor reviews those zones before they appear in your result.
More monocytes in your blood gives a higher ratio. According to the review, HDL slows both the activation of monocytes and the production of new monocytes from precursor cells.[1]
Lower HDL cholesterol gives a higher ratio. The review describes how a fall in HDL cholesterol, together with a build-up of monocytes, may play a part in diseases of the heart and blood vessels.[1]
Inflammation can affect the whole body, with more inflammatory substances in the blood. In inflammatory conditions, a high number of monocytes together with low HDL cholesterol has been reported.[1]
The Monocyte/HDL ratio is included in BioProfile 77, 87, 121 and 150.[2]
The BioProfile editorial team wrote this page on 27 October 2026 from the sources below, which we read on 27 October 2026. Every number on this page comes from one of those sources, with that source's number next to it. An expert will still review this page; after that review, the expert's name and the date of the review will appear at the top. This page explains and does not diagnose. Discuss an abnormal value with your GP.
