Abstract： Objective To evaluate the correlation between residual cholesterol(RC)and pre-diabetes(Pre-DM)conversion.Methods The data of this research came from the SENSIBILE-Cohort study,which included 2741 individuals with Pre-DM and followed up for 3 years.RC=TC-HDL-C-LDL-C.Logistic regression analysis was used to identify the factors influencing the progression of Pre-DM to DM and the return to normal blood glucose,while multiple linear regression analysis was used to identify the influencing factors for RC.Results During a 3-year follow-up period,1659 cases(60.5%)of the Pre-DM population maintained Pre-DM status,351 cases(12.8%)progressed to DM,and 731 cases(26.7%)returned to normal blood glucose.Logistic regression analysis showed that when defining Pre-DM according to ADA diagnostic criteria,high RC was the influencing factor for Pre-DM progression to DM and return to normal BG in the unadjusted model.After adjusting for age,gender,nationality,BMI,SBP,smoking,drinking,SUA,TG,exercise and meat diet,high RC may reduce the likelihood of Pre-DM returning to normal blood glucose,but RC is not a contributing factor to the progression of Pre-DM to DM.Multiple linear regression analysis shows that SBP,DBP,2 hPG,triglyceride/glucose index,Chinese visceral fat index,and lipid accumulation products are the influencing factors for RC.Conclusions High RC reduces the likelihood of Pre-DM returning to normal blood glucose.RC is not a contributing factor to the progression of Pre-DM to DM.