Serum proteomic correlates of arts and cultural engagement and their associations with health outcomes: cross-sectional and longitudinal analyses in the UK Household Longitudinal Study

Understanding of the biological mechanisms underpinning associations between arts and cultural engagement (ACEng) and health outcomes remains embryonic. This study aimed to characterize serum proteomic signatures of ACEng, investigate the relationships between ACEng and health conditions, and undertake preliminary analyses to explore whether these proteins may mediate the associations. We analysed prospective cohort data from 6,180 participants in the UK Household Longitudinal Study who had cardiometabolic protein data and/or neurology protein data. Two indices of arts engagement were generated by summing metrics of frequency and diversity of arts participation, cultural attendance, and library, archives, museum, and heritage visits. Geater ACEng was found to be consistently associated across models with differences in 17 proteins after adjusting for sociodemographic confounders and multiple testing. The enriched biological pathways identified involved cell proliferation, receptor-mediated signaling, immune regulation and inflammatory signaling. We then explored longitudinal associations between ACEng and incidence of 15 chronic diseases. ACEng was consistently associated with lower prospective risk of asthma, COPD, CVD, IHD, stroke, arthritis, hyperthyroidism, hypertension, diabetes, clinical depression, and dementia (but not with cancer, heart failure, liver disease or epilepsy). In exploratory analyses, the identified significant proteins mediated 15.95–37.70% of the associations between ACEng and cardiometabolic and respiratory diseases, arthritis, and depression, although as ACEng and proteins were measured near contemporaneously, this does not establish a causal protein pathway. Instead, these findings present, for the first time, proteomic signatures of ACEng and provide preliminary data to help generate hypotheses about potential mediation pathways to health conditions. Future longitudinal research is encouraged to test whether proteins provide causal mechanistic pathways linking ACEng to human health and disease.