We aimed to clarify the impact of the serum zinc (Zn) level grading system proposed by the Japanese society of clinical nutrition (JSCN: 80 μg/dL ≤ serum Zn level < 130 μg/dL (type A), 60 μg/dL ≤ serum Zn level < 80 μg/dL (type B), and serum Zn level < 60 μg/dL (type C)) in patients with hepatitis C virus (HCV)-related liver cirrhosis (LC) on the incidence of composite hepatic events (Com-HEs) compared with Child–Pugh (C–P) classification or albumin-bilirubin (ALBI) grade. The gene discussed is ALB; the disease is laryngotracheoesophageal cleft.