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Detecting DNA methylation patterns suggestive of variable escape from X-chromosome inactivation

Zhao, Q.; Bezerra, O. C. L.; Oros Klein, K.; Lamin, M.; Beaulieu, M.-C.; Rodger, M.; Kovacs, M.; O'Neil, L.; Brown, C. J.; Hudson, M.; Colmegna, I.; Bernatksy, S.; Gagnon, F.; Naumova, A. K.; Zhang, Q.; Greenwood, C. M.

2026-06-19 genomics
10.64898/2026.06.15.732395 bioRxiv
Show abstract

The X chromosome is often excluded from studies analyzing associations between traits and DNA methylation. In females, one copy of most genes on the X is inactivated (X-chromosome inactivation; XCI) through DNA methylation of the gene promoter on the inactive X. This leads to challenges in analyzing and interpreting DNA methylation data patterns. Particularly for sex-biased diseases and traits, there may be many loci of interest on the X chromosome, which contains about 5% of the genome. To address the need for appropriate analysis of DNA methylation data on the X chromosome, we develop a statistical approach to infer locus-specific escape from XCI sensitive to phenotype or covariate values. Performance of this method is illustrated by analysis of data from two sex-biased traits: rheumatoid arthritis which is 3-fold more common in females, and recurrent venous thromboembolism which occurs 2.5 times more often in males. Analyses of these two datasets identify new trait-associated loci on the X chromosome, demonstrate the capabilities of the new method for both bisulfite sequencing data and Illumina EPIC data, suggest at least one locus where variable escape may explain a sex-specific disease association, and rule out variable escape as a potential explanation at other loci. Graphical abstract O_FIG O_LINKSMALLFIG WIDTH=176 HEIGHT=200 SRC="FIGDIR/small/732395v1_ufig1.gif" ALT="Figure 1"> View larger version (52K): org.highwire.dtl.DTLVardef@1fd6c70org.highwire.dtl.DTLVardef@da4ee8org.highwire.dtl.DTLVardef@729512org.highwire.dtl.DTLVardef@98edb1_HPS_FORMAT_FIGEXP M_FIG C_FIG Created with BioRender (bioRender.com)

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