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Periodontitis is a complex, chronic inflammatory disease caused by pathogenic microflora that colonizes on the tooth surface evoking host immune responses which when left unchecked might result in tooth loss. Periostin is a matricellular protein that is highly expressed in the periosteum and periodontal ligament. It is an important protein involved in maintaining the integrity of the periodontal ligament and alveolar bone, hence its link in the etiopathogenesis of periodontal disease is much significant. Periostin is also expressed in various specialized tissues like heart valves, the connective tissue of lungs and kidneys where it helps in the formation of extracellular matrix. Since periostin acts as a scaffold for the formation of the extracellular matrix of various tissues and a remodeling protein in bone formation and metabolism, any disease affecting these structures would potentially influence the periostin levels. This review aims in eliciting the role of periostin in various metabolic disorders and emphasizes its role as a biomarker to scrutinize the disease progression.