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The Ecuadorian Laron and Brazilian Itabaianinha cohorts with congenital mutations in the GH and GHRH receptors, respectively, both provide a unique and arguably the purest examples to evaluate the effects of chronic severe IGF-I and both severe GH and IGF-I deficiency, respectively, with severe hypoinsulinemia being the common denominator in both cohorts (151, 152) ( Table 1

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Using multiple reaction monitoring (MRM) positive ion mode, the 1-MNA NNMT reaction product was quantified from peak area ratios using AB Sciex Analyst and MultiQuant 2.1 software and the parent precursor and Q3 masses set to m/z 137.1 and 94.1, respectively

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