Impact of regional and general aerobic exercise on molecular regulators oflipolysis and adipose tissue composition in obese women

This randomized controlled trial compared the effects of regional, general, and combined aerobic training on plasma lipolytic markers and subcutaneous fat reduction in obese women with abdominal or gluteofemoral fat accumulation. Sixty women (age 25-50 years; BMI ≥30 kg/m²) were assigned to general aerobic training (GATG; treadmill/cycling), regional aerobic training (RTG; targeted abdominal or lower-body rhythmic exercises), or combined training (CTG; 15 min general + 15 min regional), performed three times per week for 12 weeks at 55-75% heart rate reserve. Dietary intake was monitored to ensure no major changes. Anthropometric indices (weight, BMI, waist-to-hip ratio [WHR]) and plasma free fatty acids (FFAs), glycerol, and insulin were measured pre- and post-intervention. All groups demonstrated significant reductions in weight, BMI, WHR, and biochemical markers (p<0.05). The CTG achieved the greatest improvements: weight -6.38%, BMI -6.30%, WHR -13.13%, accompanied by the largest declines in FFAs, glycerol, and insulin. GATG showed superior systemic fat loss compared to RTG, but RTG still produced notable WHR and insulin reductions, suggesting a complementary role for localized exercise. The superior outcomes in CTG may reflect synergistic effects of global cardiovascular activation and targeted regional muscle engagement, potentially enhancing both systemic lipolysis and local adipose tissue responsiveness. Biochemical improvements, particularly reductions in fasting FFAs and glycerol, indicate enhanced adipocyte insulin sensitivity and lipid utilization. The pronounced insulin decline in CTG is clinically relevant for metabolic risk reduction. While "spot reduction" remains controversial, these findings support integrating regional movements within broader aerobic programs to address resistant fat depots. This study suggests that combining general and regional aerobic training offers a practical, scalable approach for improving metabolic health and body composition in obese women. Future research should employ imaging-based fat quantification, hormonal profiling, and long-term follow-up to clarify underlying mechanisms and optimize depot-specific exercise prescriptions.