BackgroundFew articles have studied pre-diabetes after sleeve gastrectomy. Bile acid, and lipid metabolism remains inconsistent in post-bariatric patients. ObjectiveTo explore bile acid and glucose, lipid, and liver enzyme changes in different diabetic status underwent sleeve gastrectomy. To discuss the impact of bariatric surgery and its potential benefits to pre-diabeticsMethods202 overweight and obese patients underwent bariatric surgery between January 2016 and October 2018 in our hospital were retrospectively reviewed. They were divided into Pre-diabetes (n=32), Non-diabetes (n=144), and Diabetes (n=26) and analyzed respectively. Data of glucose and lipid metabolism were collected from medical records from baseline and each follow-up visit.ResultSignificant improvement in body weight, glucose and lipid metabolism, and liver enzyme at P≤0.05 in prediabetics were found throughout first year post-op. Improvement of glycemic control was first seen in a month post op, followed by persistent improvement in the next 12 months. Total bile acid (TBA) decreased, associated with ALT improvement, in pre-diabetes 1-year post-surgery. There was no significant differences in HbA1c, glucose, and triglycerides (TG) between Pre-diabetics and T2DM nor between prediabetics and non-diabetics at 12 months post-surgery.ConclusionLSG is highly effective in interfering glucose and lipid metabolism as well as total bile acid of prediabetics in the first year post op. Thus, LSG is indeed an alternative for overweight and obese prediabetics