Abstract： Objective To evaluated the serum uric acid(SUA)level in elderly patients with type 2 diabetes mellitus(T2DM)and sarcopenia,and to explore the relationship between SUA and T2DM with sarcopenia.Methods A total of 522 hospitalized patients with T2DM who were admitted to the Department of Endocrinology,The First Affiliated Hospital of Xinjiang Medical University were enrolled in this study from January 2022 to September 2023.All the patients were divided into T2DM without sarcopenia group(n=431)and T2DM with sarcopenia group(Sar,n=91)according to the presence of sarcopenia.In addition,participants were divided into four groups:Q1BMI(≤23.70 kg/m2),Q2BMI(23.80～26.10 kg/m2),Q3BMI(26.20～29.00 kg/m2),and Q4BMI(>29.00 kg/m2)according to BMI quartiles.Besides,depending on SUA quartiles,they were divided intofour groups Q1SUA(≤269.00 μmol/L),Q2SUA(269.01～313.00 μmol/L),Q3SUA(313.01～363.00 μmol/L),and Q4SUA(>363.00 μmol/L).The clinical data and biochemical indexes were compared between groups.Pearson correlation analysis was used to investigate the correlation between ASMI and other indexes.The influencing factors for sarcopenia in elderly T2DM were analyzed by logistic regression.Results The age,HbA1c,and 2 hPG levels were higher,while the BMI,FC-P,SUA,ASMI,grip strength,and gait speed were lower in the Sar group than in the T2DM group(P<0.05).Pearson correlation analysis showed that SUA was positively correlated with ASMI(P<0.05).Logistic regression analysis revealed that SUA was still the influencing factor for sarcopenia after adjusting for age,BMI,and 2 hPG.The risk of sarcopenia was higher in the Q1BMI and Q2 BMI groups than in the Q4BMI group(P<0.05),and the risk of sarcopenia was higher in the Q1SUA group than in the Q4SUA group(P<0.05).Conclusion SUA is a protective factor in elderly T2DM patients with sarcopenia.Elderly T2DM patients with low SUA are prone to develop sarcopenia.