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1 H-NMR(D 2 O, ppm): 2.22.4(m, 2H, CH 2 CO 2 HN(H)Pr i 2 ), 2.52.8(m, 2H), 3.13.2(m, 1H, 3-H) 13 C-NMR(D 2 O, ppm): 40.92(CH 2 CO 2 HN(H)Pr i 2 ), 48.12(4-CH 2 ), 51.02(3-CH), 178.95(CO 2 HN(H)Pr i 2 ) t-butyl amine (571 mg, 7.81 mmol) was added to the reacting solution of D 2 O containing (S)-4-hydroxy-3-methanesulfonyl hydroxybutyric acid, so prepared from Example 3 and stirred at room temperature for 4 hours

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In the same cohort, MACE risk was found to be about 30% higher in individuals in the highest versus lowest quartile of choline or betaine plasma concentrations (115)

It is believed that early stages of frailty are amenable to interventions that could avert adverse outcomes, including the increased risk of hospitalization and premature death (116)