Zinc supplementation in patients with cirrhosis and dysgeusia: Randomized Clinical Trial

Abstract

Background: Dysgeusia has been identified as part of liver cirrhosis (LC). Since zinc (Zn) is involved in taste and LC pathophysiology, this study aimed to evaluate the effect of zinc supplementation in patients with LC. Methods: Double-blinded randomized clinical trial, controlled with placebo in patients with LC. The intervention consisted of 100mg/day of Zn for six months. Improvement of dysgeusia was evaluated according to changes in perception (PT) and recognition (RT) thresholds of five flavors evaluated by ascending molar dilutions method. Differences were assessed by determining the size and the magnitude of effects, interpreted according to Common Language Effect Size, and determining the number needed to treat (NNT). Results: 50% (n=17) of patients were male, with a median age of 57 [51-63] years. After six months, 28 patients accomplished the follow-up; in patients who receive Zn, we observed a PT at a lower molar concentration in salty (1.0 [IQR 1.0-14.7] M vs. 12 [IQR 1.0-12] M, improvement probability 58% (NNT=6)), sweet (1.5 [IQR 1.5-3.5] M vs. 3.5 [IQR 1.5-4.0] M, improvement probability 57% (NNT=6)), sour (0.48 [IQR 0.48-0.48] M vs 0.48 [IQR 0.48-2.44] M, improvement probability 65% (NNT=3)) and umami (0.40 [IQR 0.40-0.40] M vs 0.70 [IQR 0.70-0.80] M, improvement probability 74% (NNT=2)) tastes compared to placebo group. With respect to RT, patients who received Zn, recognition of umami taste was observed at a lower molar concentration (0.70 [IQR 0.40-1.17] M vs 0.90 [0.70-1.1] M, improvement probability 59% (NNT=5)) compared to placebo. Conclusion: Patients supplemented with GZn show an improvement probability of PT higher than 55% for salty, sweet, sour, and umami tastes. Meanwhile, the improvement probability of RT for umami taste is 59%.