Identification of end-stage renal disease-associated loci in X chromosome: an X chromosome-wide association study
Xiaohong Zhou
,
Dianchun Shi
,
Ming Li
,
Yibin Liu
,
Zhiming Ye
,
Wei Chen
,
Meng Wang
,
Dongying Fu
,
Yanna Wang
,
Hua Gan
,
Ping Fu
,
Xiaojun Tan
,
Yaozhong Kong
,
Jihong Chen
,
Jinghong Zhao
,
Xueqing Yu
,
Jianjun Liu
1. School of Medicine, South China University of Technology, Guangzhou 510640, China
2. Department of Nephrology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou 510080, China
3. Guangdong–Hong Kong Joint Laboratory on Immunological and Genetic Kidney Diseases, Guangzhou 510080, China
4. Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
5. NHC Key Laboratory of Clinical Nephrology (Sun Yat-sen University) and Guangdong Provincial Key Laboratory of Nephrology, Guangzhou 510080, China
6. Department of Nephrology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
7. Division of Nephrology and National Clinical Research Center for Geriatrics, Kidney Research Institute, West China Hospital of Sichuan University, Chengdu 610041, China
8. Department of Nephrology, Kaiping Central Hospital, Jiangmen 529300, China
9. Division of Nephrology, The First People's Hospital of Foshan, Foshan 528000, China
10. Department of Nephrology, Affiliated Bao’an Hospital of Shenzhen, The Second School of Clinical Medicine, Southern Medical University, Shenzhen 518101, China
11. Department of Nephrology, The Key Laboratory for The Prevention and Treatment of Chronic Kidney Disease of Chongqing, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing 400037, China
12. Lab of Human Genomics, Genome Institute of Singapore, Agency for Science, Technology and Research (A*STAR), Singapore 138672, Singapore
13. Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore 119228, Singapore
yuxueqing@gdph.org.cn
liuj3@gis.a-star.edu.sg
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Received
Accepted
Published Online
2025-02-17
2025-11-11
2026-04-14
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Abstract
X-chromosomal genetic variants have been understudied in end-stage renal disease (ESRD), which holds the promise to provide valuable insights into sexually dimorphic traits and diseases. Here we performed an X chromosome-wide association study (XWAS) in a Chinese cohort (N = 2750), comprising 1489 cases with ESRD and 1261 controls, to identify locus associated with ESRD risk. One locus showing a consistent effect direction across sex but primarily supported by the male cohort was identified in COL4A5 (P = 2.43 × 10−6) in the meta-analysis combining summary statistics from the sex-stratified XWAS. COL4A5 codes for the alpha chain of type IV collagen, which is essential for the integrity of the glomerular basement membrane and normal glomerular function. Two male-specific loci, MIR3202-2 (P = 6.85 × 10−5) and SYTL4 (P = 1.71 × 10−5), were identified in the sex-stratified XWAS in males, and expression of SYTL4, TSPAN6, NOX1, CSTF2, and PCDH19 was found to be influenced by the ESRD loci near SYTL4 based on expression quantitative trait loci (eQTL) results from the Genotype-Tissue Expression (GTEx) project. In summary, our findings revealed three X-chromosome loci linked to ESRD risk, which provided foundational knowledge for genetic risk prediction and advanced our understanding of the molecular underpinnings of ESRD.
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