Association of Osteopontin with Diabetes-Related Distress and Glycemic Control in Patients with Type 2 Diabetes Mellitus

Background: Type 2 diabetes mellitus (T2DM) is characterized by chronic metabolic dysregulation accompanied by systemic inflammation and psychological burden. Diabetes-related distress (DD) is increasingly recognized as a determinant of poor glycemic control and reduced quality of life. Osteopontin, a pro-inflammatory cytokine involved in metabolic and neuroinflammatory pathways, may serve as a link between inflammation, glycemic dysregulation, and psychological stress in T2DM. Methods: A cross-sectional analytical study was conducted among patients with T2DM (n = 300), categorized into no distress, moderate distress, and severe distress groups based on Diabetes Distress Scale-17 (DDS-17) scores (100 per group). Serum osteopontin levels, glycemic parameters (fasting blood sugar and HbA1c), inflammatory markers, and anthropometric measures including body mass index (BMI) were assessed. Group comparisons were performed using one-way ANOVA, and correlations were analyzed using correlation coefficients as appropriate. Results: DDS scores differed significantly across the three groups (F(2,297) = 549.71, p < 0.00001). Patients with severe diabetes-related distress exhibited significantly higher HbA1c and serum osteopontin levels compared to those with no or moderate distress. Correlation analysis demonstrated a graded increase in the strength of association between osteopontin, DDS scores, and HbA1c with increasing distress severity. Osteopontin was also significantly associated with BMI and inflammatory markers. Conclusion: This study provides novel evidence that elevated serum osteopontin levels are associated with increased diabetes-related distress and poor glycemic control in patients with T2DM. These findings highlight osteopontin as a potential biomarker linking psychological stress, inflammation, and metabolic dysfunction, supporting the need for integrated nutritional, pharmacological, and psychosocial strategies.