## 4 Discussion
In another ApoE\(-\)/\(-\) mouse study that looked at the development of atherosclerosis and atherosclerotic plaques using different diets, _Peptostreptococcaceae_ levels, as well as _Ruminococcaceae_, _Clostridiaceae_, _Enterobacteriaceae_, and _Streptococcaceae_ levels, were found to be significantly higher in mice with atherosclerosis than in control mice [37]. [PERSON] et al. [30; 38; 39] discovered that an omnivorous diet and trimethyl-lamine N-oxide (TMAO) production, which is important in the progression of atherosclerosis, are positively correlated with the abundance of the _Peptostreptococcaceae_ family in humans (30 omnivore and 23 vegetarian or vegan healthy adults). However, in the first two studies, specific groups of mice were studied, whereas in the third report, the authors focused on diet and microbiome metabolites. Furthermore, mice were only exposed to IH or IC in the first case. Therefore, additional research is required to uncover the differences in the results. We reported the candidate microbes at the genus level in the non-atherosclerotic group: _Bilophila_, _Romboutsia_, _Slackia_, and _Veillonella_; and in the atherosclerotic group: _Escherichia-Shigella_, _Prerotella_, and _Ruminococcaceae_. _Prerotella_ and _Ruminococcaceae_ should be highlighted from the list because they have also been implicated in other studies on a similar topic. In the study of [PERSON] et al., a total of 113 subjects were involved, diagnosed by polysomnography and examined with 165 rRNA pyrosequencing [11]. As a result, in OSA patients three enterotypes, _Bacteroides_, _Ruminococcus_, and _Prerotella_, were recognized, and a connection between the _Prerotella_ enterotype and dramatically altered arousal-relatedmetrics or sleep stages was found. In addition, another report from this study described the _Ruminococcus_ enterotype to be the most dangerous to OSA patients by examining stool samples from 93 participants [10]. Furthermore, [PERSON] et al. reported increased relative abundances in pro-atherosclerotic _Ruminococcaceae_, _Coriobacteriaceae_, and _Lachospiraceae_; and decreased relative abundances in anti-atherosclerotic _Erysipelotrichaceae_ in IH-conditioned ApoE-/- mice [17]. The third prominent microbes of the atherosclerotic group, _Escherichia Shigella_, belongs to the _Enterobacteriaceae_ family. [PERSON] et al. aimed to extensively investigate the intestinal microbiome's composition in connection to cardiovascular diseases with a total of 405 participants (218 atherosclerotic cardiovascular disease (ACVD) patients and 187 healthy controls, not checking for OSA status), using shotgun sequencing and found a higher proportion of _Enterobacteriaceae_ and _Streptococcus_ spp. in ACVD patients compared to the control group [40]. It should be noted that this latter study is the only one of those mentioned that performed shotgun sequencing, as opposed to the others, which performed 165 rRNA sequencing. In order to understand the pathological role of certain bacteria in the development of atherosclerosis, we must examine the processes induced by them Trimethylamine can be produced in the gut by high animal protein/L-carnitine diets, which can then be converted to TMAO in the liver by the action of Flavin monooxygenase 3. By increasing foam cell formation, decreasing RCT, and exerting pro-thrombotic effects, TMAO may contribute to atherosclerosis [36]. While enriched Prevotella proportions showed higher plasma TMAO levels [30], another study found that the relative abundance of TMAO was positively correlated with _Prevotella oopri_[41]. _Veillonella_, one of our candidate microbes in the non-atherosclerotic group, is one of the propionate-producing bacteria [42]. Short-chain fatty acids (SCFAs) are the major end products of gut microbial enzymatic conversion of dietary complex carbohydrate to monosaccharides. Acetate, propionate, and butyrate are the major SCFAs produced during this process, accounting for 90% of the total SCFA produced by gut bacteria [43].