Postgraduate Medical Journal最新文献

{"title":"'Bad manners'-refocusing on 'bedside manner' as a core professional behaviour for doctors.","authors":"Rakesh Patel, Elizabeth Wyse","doi":"10.1093/postmj/qgaf160","DOIUrl":"https://doi.org/10.1093/postmj/qgaf160","url":null,"abstract":"<p><p>Healthcare systems globally face unprecedented pressures, with increasing patient volumes and resource constraints affecting care delivery. While systemic factors contribute to patient dissatisfaction, individual healthcare professional behaviours significantly impact patient experience regardless of system constraints. Despite communication skills being fundamental to medical training, evidence suggests that bedside manner-historically a marker for quality of care through the eyes of patients-has deteriorated due to multiple factors, including increased workload, professional burnout, shifts from bedside to simulation-based teaching, and evolving hospital cultures that prioritize efficiency over patient-centred care. Bedside manner may seem to have little relevance against this backdrop, yet its importance has never been greater as the National Health Service (NHS) in the UK prepares to undergo reform, and medicine as a profession begins to evolve and redefine the doctor's role in the era of artificial intelligence. This commentary synthesises literature on doctor-patient communication and presents both experience- and evidence-based recommendations for three core professional behaviours that doctors can demonstrate now to positively impact patient and carer experiences. Each example is presented with relevant context, and instructions for behaving through the lens of 'good manners'. Adhering to social norms and aspiring to behave courteously will enable doctors to manage difficult situations more effectively, rebuild trust among patients or their carers, and regrow confidence in the profession. Training in interactions with patients should therefore be seen as a fundamental aspect of medical education and behavioural coaching should ensure that resident doctors never talk down to their patients.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145126058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comparison of the efficacy of 5% glucose and saline solution in shoulder joint hydraulic distension for the treatment of frozen shoulder.","authors":"Xingyu Li, Jingyi Xie, Xinxiang Zhang, Xiaoxiao Guo, Yan Li, Qin Yin","doi":"10.1093/postmj/qgaf157","DOIUrl":"https://doi.org/10.1093/postmj/qgaf157","url":null,"abstract":"<p><strong>Objectives: </strong>This prospective, randomized, double-blind, controlled study aimed to assess the effectiveness of a 5% glucose solution compared to normal saline for treating frozen shoulder via shoulder joint hydraulic distension.</p><p><strong>Methods: </strong>A total of 100 participants were randomly assigned to either the 5% glucose group (1 ml compound betamethasone +4 ml 2% lidocaine +15 ml 5% glucose) or the saline group (1 ml compound betamethasone +4 ml 2% lidocaine +15 ml normal saline). Patients were assessed at 1, 4, and 12 weeks post-treatment using the Shoulder Pain and Disability Index, the Numerical Rating Scale for pain, and active range of motion.</p><p><strong>Results: </strong>Substantial improvements were demonstrated by both treatment groups at all follow-up points (1, 4, and 12 weeks), as reflected by a decrease in Shoulder Pain and Disability Index score. However, the 5% glucose group showed significantly lower Shoulder Pain and Disability Index scores than the saline group at 4 and 12 weeks (P = 0.003 and P < 0.05, respectively). This group also experienced significantly greater improvements in shoulder abduction at 4 weeks (P = 0.003) and extension at 12 weeks (P = 0.001) than the saline group. No significant differences were noted between the groups in Numerical Rating Scale scores or shoulder range of motion at other time points.</p><p><strong>Conclusion: </strong>For patients with painful frozen shoulder lasting over a month, both treatments resulted in substantial pain relief and improved function. The 5% glucose solution produced more pronounced benefits at 4 and 12 weeks, particularly with regard to pain relief and increased shoulder mobility. Key messages What is already known about this topic: Although extensive research has been conducted on frozen shoulder, the most effective treatment has yet to be identified. What does this study contribute: This is the first study to use a 5% glucose solution as the primary distending agent in shoulder joint hydraulic distension for frozen shoulder (FS), which is a novel approach not previously explored in the literature. How might this study affect research, practice or policy: This study provides a new clinical protocol for the treatment of frozen shoulder.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145125993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Black hairy tongue caused by traditional Chinese herbal medicine.","authors":"Mengya Huang, Yi Liu, Weihua Pan, Xun Zhou, Chao Zhang","doi":"10.1093/postmj/qgaf161","DOIUrl":"https://doi.org/10.1093/postmj/qgaf161","url":null,"abstract":"","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145125969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Think like a surgeon: the T-DODAR tool for problem solving in oral examinations and clinical practice.","authors":"Petrut Gogalniceanu, Stefano Artusa, Cameron Ruckley","doi":"10.1093/postmj/qgaf146","DOIUrl":"https://doi.org/10.1093/postmj/qgaf146","url":null,"abstract":"","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145103007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical characteristics and survival outcomes of long-term responders for advanced nonsmall cell lung cancer patients with first-line PD-1/PD-L1 inhibitors: a multicenter retrospective study.","authors":"Zhijuan Du, Xiangwei Ge, Yao Li, Yuhui Qin, Hao Fan, Yahui Lv, Xiangyu Du, Zhefeng Liu","doi":"10.1093/postmj/qgaf045","DOIUrl":"10.1093/postmj/qgaf045","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Immunotherapy has shown long-term benefits in advanced nonsmall cell lung cancer patients. However, the clinical characteristics, prognosis, and selection of appropriate therapies for long-term responders (LTR) to first-line programmed cell death protein-1/programmed cell death ligand-1 (PD-L1) inhibitors remain undetermined.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;About 413 advanced nonsmall cell lung cancer patients were included from 1 June 2015 to 31 August 2021. It examined clinicopathologic data, overall survival distributions, and treatment strategies involving immune checkpoint inhibitors.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Among the patients, 213 (51.6%) were LTRs. PD-L1 expression ≥50% was observed in 39.1% of LTR patients, higher than in non-LTR patients (21.7%). After propensity score matching, Cox univariable analysis revealed pathological type (hazard ratio [HR] 0.563; 95% confidence interval [CI]: 0.391-0.811; P = .002), bone metastasis (HR 1.820; 95% CI: 1.278-2.590; P = .001), and liver metastasis (HR 2.220; 95% CI: 1.291-3.817; P = .004) as significant predictors of LTR. The pathological type (HR 0.641; 95% CI: 0.441-0.932; P = .020), bone metastasis (HR 1.593; 95% CI: 1.106-2.293; P = .012), and liver metastasis (HR 1.820; 95% CI: 1.046-3.165; P = .034) were significant predictors of LTR in Cox multivariable analysis. Significant difference showed in overall survival (P &lt; .0001) for Pembrolizumab-chemotherapy of lung squamous cell carcinoma in LTR group compared with Sintilimab-chemotherapy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Nonsquamous cell carcinoma, bone metastasis, and liver metastasis were significant predictors of LTR. LTR patients showed a higher proportion of PD-L1 expression. Compared to Sintilimab-chemotherapy, Pembrolizumab-chemotherapy may be more promising for long-term survival of lung squamous cell carcinoma patients. Key messages What is already known on this topic - Immunotherapy (IO) has demonstrated long-term survival benefits in advanced nonsmall cell lung cancer (NSCLC). However, the clinical characteristics, prognosis, and optimal treatment strategies for long-term responders (LTR) to first-line programmed cell death protein-1/programmed cell death ligand-1 inhibitors remain unclear, necessitating further investigation. What this study adds - This study identifies nonsquamous cell carcinoma, absence of bone metastasis, and absence of liver metastasis as significant predictors of LTR in NSCLC patients. LTR patients exhibit a higher proportion of programmed cell death ligand-1 expression (≥50%). Additionally, Pembrolizumab-chemotherapy shows superior overall survival outcomes for LTR with lung squamous cell carcinoma compared to Sintilimab-chemotherapy. How this study might affect research, practice, or policy - These findings provide critical insights for patient stratification and therapy optimization in NSCLC. The identification of predictive factors and superior therapeutic combina","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":"1072-1080"},"PeriodicalIF":2.7,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143990910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A novel indicator derived from heart sound energy map obtained by a wearable device can evaluate LV function.","authors":"Zhi-Jian Liu, Xiao-Hong Liu, Qing-Xue Zhang, Xiao-Hui Zhao, Xiu-Chang Li","doi":"10.1093/postmj/qgaf012","DOIUrl":"10.1093/postmj/qgaf012","url":null,"abstract":"<p><strong>Background: </strong>Assessing cardiac function is important for early diagnosis, prognosis, and out-hospital follow-up for heart failure patients. It is especially crucial to identify a cost-effective and easily adaptable approach for evaluating cardiac function at home.</p><p><strong>Objective: </strong>Our purpose was to investigate whether some metrics derived from the heart sound energy map obtained by a wearable heart acquisition device could reflect the cardiac function.</p><p><strong>Methods: </strong>99 subjects were categorized into two groups based on whether their left ventricular ejection fraction was <50%. In the heart sound energy map mode, time intervals of energy intensity between 2100 and 2400 of the first heart sound was denoted as \"a,\" 1500-1800 as \"b,\" 1200-1500 as \"c,\" and 600-900 as \"d.\" The ratio of the time difference between adjacent energy intensity intervals and the high-energy interval was calculated, referred to as the Red index [(b-a)/a], Brn index [(c-b)/b], and Yel index [(d-c)/c], respectively.</p><p><strong>Results: </strong>Significant differences were observed in the Red index and Yel index between the two groups (P < .001 and P = 0.017, respectively). The Red and Yel indices showed a significant correlation with ejection fraction (EF) value (r = -0.50 and -0.27, P < .001 and P = .008, respectively). The intraclass correlation coefficient conformance test indicated that the intragroup correlation coefficients of the Red index with EF were 0.57. Receiver operating characteristic analysis revealed that the Red index exhibits strong diagnostic value for EF values <50% with an AUC of 0.86 (95% CI: 78% ~ 94%).</p><p><strong>Conclusions: </strong>The Red index, derived from the heart sound energy map, demonstrates a significant correlation with both the EF value and Tei index and can identify the reduction of left ventricular EF.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":"988-996"},"PeriodicalIF":2.7,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143978996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mechanisms of intestinal flora in colorectal cancer.","authors":"Junchuan Li, Li Liu, Xiaoqiong Zhong, Runxin Yang","doi":"10.1093/postmj/qgaf026","DOIUrl":"10.1093/postmj/qgaf026","url":null,"abstract":"<p><p>The intestinal flora is a complex community of microbes that inhabit the digestive tract and live with their hosts symbiotically. Several gastrointestinal diseases, such as colorectal cancer (CRC), have been associated with dysbiosis, an imbalance between beneficial and opportunistic pathogens. Dysbiosis breaks the mucosal barrier, leading to inflammation and cancer. Increased numbers of harmful bacteria, such as Escherichia coli (E. coli) and Enterotoxigenic Bacteroides fragilis (ETBF), have been associated with chronic inflammation and the release of carcinogenic mediators, increasing the chances of inflammatory dysplasia. Compared with a healthy person, CRC patients showed reduced bacterial diversity and abundance, while Firmicutes and Bacteroidetes were increased. Specific bacteria have also been linked to the development and progression of CRC, such as E. coli, ETBF, and Enterococcus faecalis. Therefore, the aim was to analyze the association between the gut microbiota and CRC. Further research could assess the advantages of modulating the intestinal flora as protection for high-risk patients against CRC, affecting disease prognosis and patients' life.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":"944-948"},"PeriodicalIF":2.7,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of potential causal genes and drug targets in pulmonary hypertension based on transcriptomic analysis and Mendelian randomization.","authors":"Chengliang Liu, Fanliang Meng","doi":"10.1093/postmj/qgaf044","DOIUrl":"10.1093/postmj/qgaf044","url":null,"abstract":"<p><strong>Purpose: </strong>Currently, there is no definitive treatment for pulmonary hypertension (PH). This study aims to utilize the GEO database and conduct Mendelian randomization (MR) analysis to identify new genetic targets for PH and investigate their potential pathogenic pathways and therapeutic drugs.</p><p><strong>Methods: </strong>We identified key genes by combining the findings from MR and bioinformatics analyses of GEO datasets. We performed enrichment analysis to explore the functional roles of these key genes. Then, we constructed protein-protein interaction (PPI) and miRNA-mRNA networks to identify interacting proteins and miRNAs. Drug prediction analysis was conducted to propose potential therapeutic drugs. Finally, we validated the results through the GEO dataset, RT-PCR, and western blot experiments.</p><p><strong>Results: </strong>The joint analysis utilizing GEO databases and MR analysis identified two key genes, ITGA2B and TSPAN9 that exhibited significance across both analytical methods. The enrichment analysis indicated that the key genes were involved in critical biological functions and pathways, including cell adhesion, platelet activation, and the PI3K-Akt signaling pathway. The PPI and miRNA-mRNA networks further highlighted the significance of the key genes in PH. Drug prediction analysis revealed the potential of the key genes as therapeutic targets. The RT-PCR and western blot experiments validated the above findings.</p><p><strong>Conclusion: </strong>By integrating bioinformatics and MR analysis, we found that ITGA2B and TSPAN9 have a causal relationship with PH. Our findings offer new insights into the molecular mechanism and potential treatment targets of PH, establishing a basis for future research and clinical applications.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":"1064-1071"},"PeriodicalIF":2.7,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association between arachidonic acid and gallstone risk: cross-sectional study and Mendelian randomization analysis.","authors":"Zhanhua Gao, Jie Han, Di Chen, Quan Zhang, Weiqin Wang","doi":"10.1093/postmj/qgaf009","DOIUrl":"10.1093/postmj/qgaf009","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The formation of gallstones is a multifactorial process involving lifestyle habits, lipid metabolism disorders, and genetic factors. This study aims to explore the association between 19 types of dietary fatty acids and gallstone disease using large-scale population data, assess the correlation between dietary fatty acids and serum fatty acids, and investigate the causal relationship between plasma lipids and gallstone disease from a genetic perspective.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We employed a cross-sectional study design, combined with logistic regression analysis to evaluate the association between dietary fatty acids and gallstone disease. Pearson correlation analysis was used to assess the correlation between dietary fatty acids and serum fatty acids. Additionally, we utilized Mendelian randomization analysis to explore the causal relationship between plasma lipids and cholelithiasis and performed collocation analysis to identify genetic loci associated with cholelithiasis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Our study demonstrated a significant association between the intake of eicosatetraenoic acid (20:4) and a reduced risk of gallstone disease. The correlation between dietary fatty acids and serum fatty acids was weak, but the intake of eicosatetraenoic acid (20:4) showed a positive correlation with serum levels of arachidonic acid (ARA). Mendelian randomization analysis revealed a protective relationship between plasma lipids containing ARA (20:4) and gallstone disease and identified two SNPs in the FADS1 gene(rs174533 and rs174537)associated with gallstone disease.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Our study identifies a significant association between ARA intake and reduced gallstone risk, underscoring its potential in gallstone prevention. The weak correlation between dietary and serum fatty acids suggests complex physiological regulation mechanisms. Mendelian randomization analysis establishes a protective causal link between specific plasma lipids containing ARA and gallstone disease, highlighting the genetic underpinnings of gallstone formation. This research provides a foundation for dietary interventions and underscores the importance of genetic factors in lipid metabolism for future gallstone research and clinical management. Key message What is already known on this topic?  Gallstone formation is a multifactorial process, and PUFAs may have a preventive effect, but the specific relationships between dietary fatty acids, serum fatty acids, plasma lipids, and gallstone disease are not well-established. What this study adds?  This study finds a significant association between eicosatetraenoic acid (20:4) intake and reduced gallstone risk, and establishes a protective causal link between plasma lipids containing arachidonic acid (20:4) and gallstone disease through Mendelian randomization analysis. How this study might affect research, practice, or policy?  The results highlight the potential of d","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":"967-979"},"PeriodicalIF":2.7,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143047636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of cardiovascular health in the associations between insulin resistance, future cardiovascular disease, and all-cause mortality.","authors":"Weida Qiu, Chang Xiong, Kehao Zeng, Liwen Li, Zhiping Gao","doi":"10.1093/postmj/qgaf033","DOIUrl":"10.1093/postmj/qgaf033","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Whether cardiovascular health (CVH) modifies the associations between insulin resistance (IR) and prognosis remains unclear. This study aims to evaluate the varying relationships between IR, future cardiovascular disease (CVD), and all-cause mortality across different CVH statuses.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This was a nationwide cohort study using data from the China Health and Nutrition Survey. The CVH was assessed using the Life's Essential 8 (LE8) metrics, and IR was determined by the homeostasis model assessment of insulin resistance (HOMA-IR) index and the triglyceride-glucose (TyG) index. The study outcomes included incident CVD and all-cause mortality.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;47.0% of the included participants (n = 8635) were men, and the mean age (SD) was 49.7 (15.8) years, with 37.5%, 51.6%, and 10.9% having poor, intermediate, and ideal CVH. During a 6-year follow-up, 482 (5.6%) participants had incident CVD, and 435 individuals died (incidence rate: 7.9 (95% CI: 7.2, 8.7) 1000 person-years). HOMA-IR and the TyG index were positively associated with increased risks of CVD and mortality among participants with intermediate or poor CVH, while no significant associations were found between IR indexes with CVD and death in those with ideal CVH (P for interaction &lt; .05). 13.0% and 16.8% of the associations between CVH and CVD were mediated by HOMA-IR and the TyG index. Similar significant indirect effects of HOMA-IR and the TyG index on the relationship between CVH and all-cause mortality were observed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;CVH significantly modified the associations between two IR surrogates and long-term CVD and all-cause mortality. Increased risk probabilities of future CVD and mortality were observed among individuals with intermediate or poor CVH. IR mediated a substantial proportion of the associations between CVH and CVD and all-cause mortality, emphasizing the importance of maintaining healthy behaviors and factors to reduce the burden of CVD and mitigate the detrimental impact of IR. Key message What is already known on this subject  The global prevalence of insulin resistance (IR) and diabetes mellitus (DM) is extremely high and their associated disease burden is heavy. Ideal cardiovascular health (CVH) is significant associated with a lower risk of IR and better prognosis. What this study adds  Only 10.9% of the participants maintained ideal CVH in this large Chinese cohort, while more than one-third had poor CVH. CVH significantly modified the associations between two IR surrogates and long-term CVD and all-cause mortality. Increased risk probabilities of future CVD and mortality were observed among individuals with intermediate or poor CVH. IR mediated a substantial proportion of the associations between CVH and CVD and all-cause mortality. How this study might affect research, practice, or policy  Our study indicated that a large number of Chinese citizens still have ","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":"1025-1033"},"PeriodicalIF":2.7,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}