As an important protein coding gene, studies of IGFBP7 have mainly focused on its suppressive role in various human malignancies, including thyroid carcinoma, cholangiocarcinoma, gastric cancer, hepatocellular carcinoma and breast cancer.11, 13, 14 However, there are reports that the effects of IGFBP7 involve insulin resistance and the risk of metabolic syndrome,33 which are considered closely related to the development of osteoporosis.34, 35, 36 More importantly, recent studies have reported that IGFBP7 may play considerable roles in bone metabolism. This evidence concerns the gene IGFBP7 and cholangiocarcinoma.