Establishment of reference ranges and stability assessment for target height completion rate based on the China Health and Nutrition Survey (CHNS)

Background Height SDS is a well-established and effective screening indicator for clinical growth assessment. Nevertheless, as a purely population-relative metric, it does not in isolation incorporate parental height information. To complement the conventional SDS-based evaluation, we propose the Target Height Completion Rate (THCR = adult height/genetic target height × 100%), an index additionally adjusted for parental genetic height. Based on a large population-based cohort from the China Health and Nutrition Survey (CHNS), this study aims to establish population-level reference ranges of THCR in general Chinese adults and systematically evaluate its cross-subgroup stability, to provide a baseline benchmark for clinical THCR evaluation and future disease cohort research. Methods Data were drawn from the China Health and Nutrition Survey (CHNS, 1989–2015), yielding 5,098 adult individuals (≥18 years; 3,122 males, 1,976 females) with matched parental height records. Genetic target height was calculated using the Tanner method [males: (father's height + mother's height + 13)/2; females: [father's height + mother's height – 13]/2]. After calculating THCR, its associations with sex, birth cohort, urban-rural residence, educational attainment, and other factors were evaluated, and percentile reference ranges were established. Results THCR exhibited an approximately normal distribution, with a mean of 102.19% (SD 3.25%) and a median of 102.18%. Female THCR (102.99% ± 3.28%) was higher than male THCR (101.69% ± 3.13%) by 1.30 percentage points. Showed a weak positive correlation with THCR (low education group 101.87% → high education group 102.67%), and the univariable urban-rural difference (0.30 pp; urban 102.38% vs. rural 102.08%, P = 0.002) was attenuated and no longer significant after adjustment for educational attainment (+0.14 pp, P = 0.156), indicating that it largely reflected the higher educational attainment of urban residents. Conclusions THCR in the general Chinese population remained stably centered around 102%, with minimal between-subgroup differences (all < 1.5 percentage points across cohorts from the 1950s onward). The percentile distribution established in this study provides a baseline reference for future disease cohort studies.