Before I investigate, do you know a reliable way to truncate a 24-bit file to 16-bit?
Certain audio editors can do it. iZotope RX has that option.
I think Media Center can even do it if you disable dither before conversion, but I have not tested to see if that output matches the result I get from RX.
If what you're thinking is to enable the +6dB option, truncate it to 16-bit and see if it matches the source file, I tested that and it does not.
I've looked into it a bit more, and it seems that decoding HDCD tracks automatically reduces the volume by 6dB. This is to provide additional headroom for the Peak Extend feature that some discs may use.
The +6dB is to restore the original volume level before HDCD decoding - however it does not account for the Peak Extend feature, so if the disc uses this, the track may be pushed to clipping with the +6dB option enabled.
I have tested this with one of my HDCD discs that has Peak Extend enabled, and it was indeed pushed to clipping with dBpoweramp's +6dB option enabled.
Since dBpoweramp does not account for this, and since I always analyze tracks and use Volume Leveling in Media Center anyway, I see no reason to ever enable the +6dB option during conversion.
Without using Volume Leveling, at best it makes tracks a bit louder, at worst it pushes tracks to clipping.