The Effect of Zinc Agent in 219 Patients with Zinc Deficiency-inductive/Idiopathic Taste Disorder: A Placebo Controlled Randomized Study

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  • Ikeda Minoru
    Department of Otolaryngology-Head and Neck Surgery, Nihon University School of Medicine
  • Kurono Yuichi
    Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University
  • Inokuchi Akira
    Department of Otolaryngology, Head and Neck Surgery, Faculty of Medicine, Saga University
  • Takeda Noriaki
    Department of Otolaryngology, Tokushima University School of Medicine
  • Aiba Tsunemasa
    Department of Pediatric Otolaryngology, Osaka City General Hospital
  • Nomura Yasuyuki
    Department of Otolaryngology-Head and Neck Surgery, Nihon University School of Medicine
  • Sakagami Masafumi
    Department of Otolaryngology, Hyogo College of Medicine

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Other Title
  • プラセボ対照無作為化試験による亜鉛欠乏性または特発性味覚障害219例に対するポラプレジンク投与の臨床的検討
  • プラセボ タイショウ ムサクイカ シケン ニ ヨル アエン ケツボウセイ マタハ トクハツセイ ミカク ショウガイ 219レイ ニ タイスル ポラプレジンク トウヨ ノ リンショウテキ ケントウ

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Abstract

Diagnosis and treatment of taste disorders are challenging because the disorder can only be determined by the awareness of the patient. Hence, these disorders still require comprehensive evidence. We conducted a randomized, placebo-controlled double-blind study to investigate the effect of polaprezinc, a zinc-containing agent, in 219 patients with either zinc deficiency-inductive or an idiopathic taste disorder. As a result, the zinc-treated arm experienced a statistically significant improvement against the placebo-treated arm in the perceptible threshold scores of the filter-paper disk method 8 weeks after the administration of the investigational drug. Moreover, the effect lasted for 4 weeks after discontinuation of the drug. However, the effective ratios based on the initial criteria were 55.6% in the treatment group and 43.2% in the placebo, where no statistical significance was recorded. Sex and degree of depression could be two of the potential factors to explain this discrepancy. Furthermore, the effect was not significant among male patients and patients with a high depression score based on the Self-rating Depression Scale (SDS) test. These results indicate that determining the symptom among such patients remains undisclosed. Whereas, in approximately 77%, or 168 patients with “normal” SDS scores and with completely impaired taste qualities, the ratio of effective cases reached 60.9% in the zinc-treated group, the ratio of the placebo-treated group reached 39.5%, resulting in a statistical significance. This may be partly because of a problem in the adaption of male subjects to the gustatory analyses, especially to the identification of saltiness and sourness. Care must also be taken regarding the depressive state of patients when diagnosing and treating taste disorders. Taste disorders caused by depression may not be cured by zinc supplementation due in part to the fact that the symptom is based on a mental issue, and due in part to the conservative responding bias generated by the depression itself, which may inhibit accurate and precise diagnosis of the disorder. In conclusion, administration of a zinc agent is effective for patients with taste disorders, provided selection of appropriate patients is performed, and that proper examination and evaluation are conducted. The present study also indicated that examining depressiveness based on the SDS scores and investigating disturbance of each taste quality using the filter-paper disk method are recommended for the diagnosis and determination of the treatment effect of a taste disorder.

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