Gross combined weight rating is a manufacturers number used to protect the drive train, which helps keep warranty costs lower. If you are close on this number, or just over, and your truck is newer/low mileage, your engine, transmission, and all things moving back to rear wheels are likely to be able to sustain this slight overload for quite a while. On an older/high mileage truck you may have failure, while staying just under this number.
Since the gearing changes the workload, 4.10 will have a higher combined towing rating than say 3.73 in the same exact truck.
Jerry