An Update on Pharmacological and Clinical Aspects of S-adenosylmethionine in Metabolic Syndrome

Document Type : Review Article

Authors

1 Department of Clinical Pharmacy, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran.

2 Department of Clinical Pharmacy, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.

3 School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.

10.30476/tips.2026.109859.1338

Abstract

Abstract
S-adenosylmethionine (SAMe), recognized as the principal methyl donor in metabolic reactions, has recently attracted growing research interest. It has been investigated as a potential biomarker for cardiovascular diseases and various malignancies. Although SAMe supplements have been available for more than five decades, evidence supporting their clinical efficacy across most proposed indications remains limited. Given the global impact of metabolic syndrome, this study aims to review current evidence regarding the role of SAMe in its pathophysiology.
Relevant studies assessing the association between SAMe and metabolic syndrome in humans or animal models were identified through searches of Scopus, PubMed, and Google Scholar databases from beginning to 2025, following standard narrative review methodology.
Approximately 50 relevant publications were identified, addressing the relationship between SAMe levels and coronary artery disease, besides the effect of SAMe supplementation and hypertension, ischemia, aortic dissection, obesity, diabetes, heart failure, myocardial infarction, and liver disorders such as metabolic dysfunction-associated steatohepatitis (MASH), cirrhosis, cholestasis, jaundice, and viral hepatitis.
Findings on the therapeutic role of SAMe supplementation remain limited and often contradictory. As both SAMe deficiency and excess appear to contribute to the development of metabolic syndrome, further research exploring its dose-dependent effects is essential.

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