All study subjects were required to obtain full informed consent, and the study was subject to approval by the hospital ethics committee. Case group: 50 patients with lower extremity deep vein thrombosis who were hospitalized in the First Affiliated Hospital of Bengbu Medical University from January 2023 to December 2023 were selected, and the diagnostic criteria for lower extremity deep vein thrombosis were adopted from the third edition of the 2017 Chinese Guidelines for the Diagnosis and Treatment of Deep Vein Thrombosis. The exclusion criteria were patients with thrombosis during pregnancy, combination of malignant tumor or hematologic disease. Control group: 50 healthy people who underwent physical examination at the health examination center of the First Affiliated Hospital of Bengbu Medical University in the same period were selected.

Case group: fasting for 12 hours, 10 ml of peripheral menstrual blood was added into EDTA anticoagulation tubes from 06:00 to 08:00 the next morning; control group: blood specimens were taken on the day of medical examination. The collected blood specimens were frozen and stored in an ultra-low temperature refrigerator at −80˚C. The blood specimens of the case group and control group were tested by ELISA kit and recorded.

The data in this study were analyzed using SPSS 26.0 statistical software. Measurement data were summarized as mean ± standard deviation ( χ ¯ ± s ), and comparisons between two groups were performed using the t-test. Count data were presented as [n (%)] and analyzed using the χ² test for comparisons between groups. A p-value of less than 0.05 was considered statistically significant.

As Table1 showed that the study population consisted of 21 males and 29 females in the case group, with an age range of 28 to 73 years, and 23 males and 27 females in the control group, with an age range of 29 to 75 years. No significant differences were found between the two groups in terms of gender and age (P > 0.05).

The expression of NF-kβ and HIF-1α were measured by ELISA in both groups. A t-test was performed on the concentration values measured by ELISA. Table 2 and Figure 1 illustrated that NF-kβ and HIF-1α expression were significantly higher in blood samples from patients with DVT than in normal subjects, and the difference was statistically significant (P < 0.001).

NF-κβ is a critical transcription factor involved in regulating immune and inflammatory responses [8]. Under normal conditions, NF-κβ exists in the cytoplasm bound to an inhibitor. Upon activation, it translocates to the nucleus to regulate the expression of various inflammation-related genes, including those encoding cytokines, chemokines, and adhesion molecules [9].

In thrombus formation, NF-κβ activation can be triggered by factors such as changes in blood flow dynamics, endothelial injury, and local inflammation [10] [11]. This activation not only amplifies the inflammatory response but also potentially exacerbates thrombus formation. The elevated NF-κβ levels observed in DVT patients suggest a heightened inflammatory state, which could contribute to the stabilization and growth of the thrombus.

HIF-1α is a transcription factor that is primarily activated in response to hypoxia. It regulates the expression of genes related to hypoxia responses, such as VEGF (vascular endothelial growth factor) [12] and EPO (erythropoietin), promoting angiogenesis, erythropoiesis, and metabolic adaptation [13] [14]. Local hypoxia is a common occurrence in thrombus formation, especially in areas with reduced blood flow or vascular occlusion.

The elevation of HIF-1α in DVT patients indicates that hypoxic conditions are present and that the hypoxic response has been activated. HIF-1α not only serves as a marker of hypoxia but may also play a direct role in thrombus formation and development. For instance, HIF-1α can stimulate endothelial cells to produce more VEGF, which promotes angiogenesis and repair but might also disrupt local blood flow and exacerbate thrombus growth [15].

There may be an interaction and synergistic effect between NF-κβ and HIF-1α [16] [17]. Under hypoxic conditions, NF-κβ can activate the expression of HIF-1α, further enhancing the hypoxic response [18]. Conversely, HIF-1α activation might influence inflammatory responses by modulating NF-κβ pathways [19]. This interaction could exacerbate the inflammatory and hypoxic conditions in DVT, creating a vicious cycle.

The study results suggest that NF-κβ and HIF-1α could be significant clinical biomarkers for DVT [20]. Their elevated levels reflect severe inflammation and hypoxia in these patients, which are closely related to thrombus formation and progression. Thus, these biomarkers not only help assess the severity of the condition but might also serve as new therapeutic targets.

Monitoring NF-κβ and HIF-1α levels could enhance the understanding of the patient’s pathological state and aid in developing more precise treatment strategies. Targeting NF-κβ and HIF-1α may help alleviate inflammation and improve hypoxia, potentially reducing thrombus formation and recurrence.