“…It is worth mentioning that most of the up-regulated proteins in hyperplasia identified are mitochondrial proteins, involving cytochrome b-c1 complex subunit 1, enoyl-CoA hydratase, 60 kDa heat shock protein, etc., suggesting the importance of abnormal mitochondrial activity in the pathogenesis of PHPT. Although this research could not create a biomarker panel, the changes in mitochondrial proteins expression yield important direction for future studies to differentiate parathyroid hyperplasia and adenoma, which remained a significant challenge to dissolve (Akpinar et al, 2017). Although parathyroid adenomas account for approximately 85% cases of PHPT (Carling, 2001), its pathogenesis is only partially understood.…”